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Initial experiences with clozapine at Kenmore Psychiatric Hospital
Objective:
To replicate overseas experience with clozapine, a new antipsychotic drug reputed to be effective in producing major improvement in a high proportion of patients with treatment-resistant schizophrenia.
Design And Setting:
A prospective clinical trial at Kenmore Psychiatric Hospital, Goulburn, NSW. This paper is a preliminary communication covering 14 to 18 weeks after commencement of clozapine.
Patients:
Twelve patients with treatment-refractory chronic schizophrenia, chosen on the basis of the severity of their disability.
Intervention:
After existing medication was changed to be compatible with clozapine, it was reduced to the minimum level acceptable for staff and patient safety. Clozapine was then introduced gradually while other medication was withdrawn.
Outcome Measures:
Progress was monitored in terms of clinical presentation, side effects, use of supplementary medication and assessments by means of three standardised scaling systems.
Results:
None of the patients deteriorated. Of six patients aged 35 years or less, three showed dramatic improvement and three showed clinically significant improvement. None of the six older patients showed major improvement, except that extrapyramidal symptoms were reduced in all cases. Drowsiness and hypersalivation were the only common side effects.
Conclusions:
These preliminary findings are consistent with results reported overseas.