G. Abraham et al., THE EFFECTS OF CLOZAPINE ON SYMPTOM CLUSTERS IN TREATMENT-REFRACTORY PATIENTS, Journal of clinical psychopharmacology, 17(1), 1997, pp. 49-53
Preliminary results of a double-blind clozapine study in a population
of chronic psychotic patients at a state psychiatric facility are repo
rted. Thirty ''treatment-refractory'' schizophrenic patients given a d
iagnosis according to DSM-III-R criteria (mean age of 44 +/- 9.1 years
and a duration of illness of 24.9 +/- 8.8 years) who received 300 mg
or 600 mg of clozapine and randomized in a double-blind fashion were a
nalyzed. Subjects were evaluated using the Brief Psychiatric Rating Sc
ale (BPRS) and the Clinical Global Impression (CGI) Scale on a weekly
basis for 16 weeks. Based on the changes in their CGI scores at week 1
6 of clozapine treatment, subjects were retrospectively categorized as
''improvers'' (N = 12) and ''nonimprovers'' (N = 18). The two groups
were compared for changes in total BPRS and BPRS factor scores. In ter
ms of total BPRS scores, we expected a, difference between the two gro
ups because they were categorized based on changes in their CGI scores
. However, the total BPRS scores in improvers showed a significant dec
rease by week 6 of clozapine treatment. On analyzing the four BPRS fac
tors, the improvers showed improvement in the thinking disturbance fac
tor by week 1 that remained steady from week 7. On the hostility-suspi
ciousness factor, the improvers showed an improvement across time when
compared with nonimprovers. The withdrawal-retardation factor showed
improvement in both groups across time, whereas the anxiety-depression
factor was least influenced by clozapine. These observations suggeste
d that all BPRS symptom factors did not uniformly contribute to improv
ement in overall psychopathology, which was observed as a decrease in
total BPRS scores.