CLOZAPINE AS A TREATMENT TOOL - ONLY IN RESISTANT SCHIZOPHRENIC-PATIENTS

Evidence indicates that clozapine is effective in the management of tr eatment-resistant schizophrenia and in affective psychoses. To examine whether affective components within the boundaries of the schizophren ia spectrum imply specific psychopathological characteristics of respo nse to treatment, 60 patients with a treatment resistant schizophrenia spectrum disorder who were treated with clozapine (75-600 mg/d) were evaluated in a naturalistic, open, follow-up study. The group comprise d 41 patients with and 19 without bipolar features (43 men and 17 wome n, mean age 34.3 years). Patients were evaluated with the Brief Psychi atric Rating Scale (BPRS) during the first year of treatment. The resu lts show a significant improvement in scores in both groups (P < 0.001 ) compared with the baseline evaluation. A higher percentage of respon ders was seen in the 'affective' group. No typical psychopathological characteristic or symptom cluster predicting the response to treatment was identified. During the study, 15 patients discontinued treatment: six for lack of efficacy, five for non-compliance and four for advers e events. The study confirms the efficacy of clozapine in the treatmen t of schizophrenia spectrum disorders, particularly in patients with b ipolar features.