THE EFFECTS OF CLOZAPINE ON SYMPTOM REDUCTION, NEUROCOGNITIVE FUNCTION, AND CLINICAL MANAGEMENT IN TREATMENT-REFRACTORY STATE-HOSPITAL SCHIZOPHRENIC INPATIENTS

Thirty chronically hospitalized, refractory schizophrenic patients wer e evaluated while on typical neuroleptics and again after 12 weeks of clozapine treatment. Patients demonstrated small but statistically sig nificant reductions in total Brief Psychiatric Rating Scale (BPRS) sym ptoms, need for seclusion and restraint, and PRN medications, and they frequently were transferred to a less restrictive treatment environme nt. Neuropsychological test data from a subset of patients suggested i mprovement on measures of verbal fluency and graphomotor speed, but de terioration on measures of visual memory and executive/frontal ability . Clozapine's different effects on multiple neurotransmitter systems m ay be responsible for its mixed effects on cognitive abilities. No sig nificant relationships were found between symptom reduction, cognitive improvement, and transfer to a less restrictive environment.