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Clozapine therapy for older veterans
M Sajatovic1, L F Ramirez, D Garver
1Cleveland Veterans Affairs Medical Center, Brecksville, Ohio 44141, USA.
Psychiatric Services (Washington, D.C.)
|April 3, 1998
Summary
Clozapine effectively treats older veterans with treatment-resistant psychosis. Younger older adults (55-64) showed better improvement than those 65+, indicating age impacts clozapine response.
Area of Science:
- Geriatric Psychiatry
- Pharmacological Treatments
- Psychosis Management
Background:
- Older adults with primary psychosis often present treatment resistance.
- Clozapine is a key medication for refractory psychosis but its efficacy in older populations requires specific investigation.
Purpose of the Study:
- To evaluate clozapine treatment effectiveness in veterans aged 55 and older with treatment-refractory psychosis.
- To compare treatment outcomes between different age subgroups within the older adult population.
Main Methods:
- A five-year retrospective study of patients aged 55+ receiving clozapine for treatment-refractory psychosis.
- Collected baseline demographic, clinical, and psychopathology data.
- Assessed psychopathology using the Brief Psychiatric Rating Scale (BPRS) and involuntary movements with the Abnormal Involuntary Movement Scale (AIMS) quarterly.
Main Results:
- Clozapine therapy led to overall improvement in psychosis symptoms among older adult veterans.
- Patients aged 55-64 demonstrated a mean BPRS score improvement of 19.8%, significantly higher than the 5.7% improvement in those aged 65+.
- A mean improvement of 16.6% in total score was observed for involuntary movements (AIMS).
Conclusions:
- Clozapine is a valuable therapeutic option for older adults experiencing treatment-refractory psychosis.
- Age is a significant factor, with patients aged 55-64 potentially benefiting more from clozapine than those aged 65 and older.