Tolerability of long term clozapine treatment

Psychopharmacology (Berl). 1989:99 Suppl:S105-8. doi: 10.1007/BF00442572.

Abstract

Tolerability of long term clozapine treatment (7-8 years) was investigated in 27 female patients (age 34-77 years). Diagnosis according to ICD 9 was schizophrenia in 21 patients, severe psychomotor agitation with mental deficiency in 4 patients and an "endogenous" depression in 2 patients. All patients had previously been treated with different neuroleptics but with inadequate response or distressing side effects. The duration of the disorder was 10-36 years, duration of hospitalisation 10-36 years. At the day of investigation the total dose of clozapine ranged from 52-826 g, the average total dose being 385 g. The daily dose of clozapine ranged from 75 to 600 mg, the average daily dose being 225 mg. Only 2 patients were treated exclusively with clozapine, the other 25 patients were also receiving other neuroleptics. Seventy eight per cent of the investigated patients complained about hypersalivation and 63% showed overweight. In 37% of the patients the EEG demonstrated abnormalities. Mild parkinsonism was reported in 15% and akathisia in 11% of the patients, all these patients being on combined treatment. Clozapine did not induce tardive dysakinesia (TD) in any of the patients within a treatment period of 7-8 years. It is concluded that a potential benefit of clozapine includes a low incidence of neurological side effects even after long term administration.

MeSH terms

  • Adult
  • Aged
  • Basal Ganglia Diseases / chemically induced
  • Clozapine / adverse effects*
  • Clozapine / therapeutic use
  • Dibenzazepines / adverse effects*
  • Drug Tolerance
  • Electroencephalography
  • Female
  • Humans
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Schizophrenia / complications
  • Schizophrenia / drug therapy
  • Schizophrenic Psychology

Substances

  • Dibenzazepines
  • Clozapine