DIMINISHED SUICIDAL AND AGGRESSIVE-BEHAVIOR, HIGH PLASMA NOREPINEPHRINE LEVELS, AND SERUM TRIGLYCERIDE LEVELS IN CHRONIC NEUROLEPTIC-RESISTANT SCHIZOPHRENIC-PATIENTS MAINTAINED ON CLOZAPINE

Impulsiveness and aggressiveness may be the most common behavioral cor relates of central serotonergic dysfunction. The aim of this study was to determine whether clozapine, an atypical antipsychotic agent with a potent serotonergic antagonistic activity, affects impulsiveness and aggression. Its effects on serum lipids, platelet-poor plasma seroton in (5-HT), and norepinephrine (NE) levels were also studied. Thirty ne uroleptic-resistant chronic schizophrenic patients, maintained on cloz apine for 1 year, were evaluated for aggressiveness, impulsiveness, an d suicidality in comparison with 30 chronic schizophrenic patients mai ntained on classical antipsychotic agents for the same period of time. Clozapine treatment was associated with less impulsiveness (p<0.05), aggressiveness (p<0.01) and fewer suicidal attempts (p<0.05). Serum tr iglycerides and plasma NE levels were significantly higher(p<0.01 and p<0.0001, respectively) in the patients treated with clozapine, as com pared with patients treated with classical neuroleptic drugs. The auth ors conclude that long-term clozapine treatment may be effective in co ntrolling aggressive, impulsive, and suicidal behavior in neuroleptic- resistant chronic schizophrenic patients. The elevated plasma NE level s in patients treated with clozapine as compared to those treated with classical neuroleptic drugs may be relevant for the anti-aggressive/a ntisuicidal activity of clozapine.