[Clozapine in adolescence onset schizophrenia]

Clozapine is an atypical neuroleptic agent given when schizophrenia is resistant to other neuroleptic drugs. Its use is restricted because of the risk of agranulocytosis, which appears in 1% of cases and therefore necessitates frequent WBC counts. We cite the only 2 surveys of the treatment of adolescents with clozapine and report our experience. We treated 7 boys and 6 girls between the ages of 14-17 years (mean 16.6) with clozapine after failure of all other neuroleptic agents tried. Our usual dose was 300 mg/day, for an average of 245 days. In only 2 patients was improvement only partial. In 1 treatment had to be stopped because of symptomatic orthostatic hypotension which appeared 36 hours after the drug was started. In our opinion, clozapine should be considered when severe schizophrenia in adolescents is refractory to other neuroleptic agents, provided the WBC count is monitored.