Clinical outcome to clozapine treatment in chronic psychiatric inpatients

1. A review of the medical records in a state psychiatric hospital was cond ucted to evaluate the clinical efficacy of the atypical antipsychotic, cloz apine. 2. Using the Brief Psychiatric Rating Scale (BPRS), four groups of schizoph renic inpatients (n=59) were operationally defined: Nonresponders (<20% dec rease from pre-drug baseline); Short-term Pharmacological Responders (20% d ecline, but not sustained); Long-term Pharmacological Responders (maintaine d a 20% decline) and Clinical Responders (maintained a 20% decline and achi eved a BPRS less than or equal to 36; the criterion of Kane et al. 1988). 3. There were 7 NRs, 13 STPRs, 21 LTPRs and 18 CRs. 4. The STPR, LTPR and CR groups improved significantly within the first mon th of treatment and reached a 20% decrease in BPRS by 3 months. CRs require d 5 months to attain a BPRS less than or equal to 36. These criteria were r eached at the same average doses (about 300-400 mg/day). 5. The proportion of CRs (30%) in this retrospective, naturalistic study, i s remarkably close to the results of the definitive study by Kane et al. 19 88. These results are also consistent with many of the controlled research studies of clozapine in hospitalized, treatment refractory psychiatric pati ents.