clozapine and Schizotypal-Personality-Disorder

Leponex (clozapine) is an atypical neuroleptic indicated in severe schizophrenia, launched in France in December 1991. The safety and efficacy data pertaining to 1,062 patients treated on a compassionate needs basis between May 1989 and December 1991 constitute the first French experience on the drug. The results of an interim analysis pertaining to 602 patients, i.e. available data on 03-15-1992, generally collected on a retrospective basis, by means of a specific questionnaire are reviewed. The population included patients with severe and long-standing schizophrenia i.e. 15.71 +/- 9.3 years, resistant to usual neuroleptic therapy (90.86% of cases), and rarely with a history of intolerance to this class (2.49%). The indication was in the majority of the cases a paranoid schizophrenia (67.2%). The mean maintenance daily dose was 419 mg/d (+/- 152). Overall, with respect to associated drugs, neuroleptics were recorded in 16.4%, another psychotropic drug in 44.7% and symptomatic treatments for extrapyramidal disorders in 21.3% of patients. Of interest is the fact that, for those patients started on Leponex more recently, the drug is more often prescribed on a single basis. Leponex was stopped in 24.3% for the following reasons: adverse events 10.6%, lack of efficacy 6%, non compliance 3.8%, other reasons 3.8%. The adverse event profile is consistent with the literature data, taking into account the fact that certain adverse events were more commonly described: fatigue of lower limbs 11.8%, leucocytosis 19.8% and eosinophilia 4.3%.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Clozapine; Female; Follow-Up Studies; France; Hematologic Diseases; Humans; Male; Middle Aged; Retrospective Studies; Schizophrenia; Schizotypal Personality Disorder; Treatment Outcome

One hundred twenty schizophrenic patients were treated with clozapine for two months in accordance with a standard trial protocol at ten research centers in the USSR, Czechoslovakia, Hungary, Poland, Bulgaria, and in the GDR. The daily dose ranged from 50 mg to 550 mg (mean: 272.1 mg for responders; 298 mg for nonresponders). In 94 patients (78%) the disease was clearly progressive; in 57 (47.5%) it was continuous; in 63 (52.5%) it was episodic. Before the start of clozapine treatment, 95 of the patients (79%) had been receiving other neuroleptics. There was a positive therapeutic response in 80% of the responding patients. The effect of clozapine was closely related to the dominant syndrome structure of the psychosis: a positive response was noted in 89% of patients with delusional, hallucinatory-delusional, and catatonic states and in 60% of patients with affective-delusional syndromes. Moderate side effects were noted in 87 patients (73%). The incidence of side effects reached a peak during the first four weeks of treatment and then declined despite maintenance of or even an increase in the daily clozapine dose. Hematological changes (moderate leukocytosis and thrombocytopenia) were noted in eight patients (6.7%).

Topics: Adolescent; Adult; Aged; Clinical Trials as Topic; Clozapine; Dibenzazepines; Dose-Response Relationship, Drug; Female; Humans; Male; Middle Aged; Psychiatric Status Rating Scales; Schizophrenia, Catatonic; Schizophrenia, Paranoid; Schizotypal Personality Disorder

Topics: Adult; Antipsychotic Agents; Clozapine; Comorbidity; Dose-Response Relationship, Drug; Humans; Male; Obsessive-Compulsive Disorder; Schizotypal Personality Disorder; Treatment Outcome

Topics: Agranulocytosis; Antipsychotic Agents; Clozapine; Granulocyte Colony-Stimulating Factor; Histocompatibility Testing; Humans; Male; Middle Aged; Polymerase Chain Reaction; Risk Factors; Schizophrenia; Schizophrenic Psychology; Schizotypal Personality Disorder