Improvement patterns in schizophrenic “nonresponders” treated with clozapine: A Systematic Study Over 1 Year

Abstract

Forty-four chronic schizophrenic inpatients with unsatisfactory response to conventional neuroleptics were switched to clozapine in flexible dosage and followed up systematically for up to 1 year with the Positive and Negative Syndrome Scale (PANSS), Nurses Observation Scale for Inpatient Evaluation (NOSIE), Clinical Global Impressions (CGI), and the UKU side effect rating scale. Thirty-nine patients were evaluable; 35 completed 6 months, and 25 completed 1 year. There was a highly significant reduction in PANSS, NOSIE, and CGI scores already after 3 weeks. After 6 months there was a mean reduction of total PANSS score of about 50%, and about half of the patients obtained at least 50% reduction. Positive symptoms showed a significantly greater improvement than negative ones. Least improvement was seen in cognitive disturbance. Depression and guilt feeling were favourable prognostic factors, whereas cognitive disturbances were unfavourable predictors of overall improvement. The side effect spectrum was dominated by sedative and autonomic symptoms, especially increased salivation. No marked decrease in leucocytes was seen.

□Chronic schizophrenia, Clozapine, Drug treatment.