A DOUBLE-BLIND COMPARATIVE-STUDY OF CLOZAPINE VERSUS CHLORPROMAZINE ON CHINESE PATIENTS WITH TREATMENT-REFRACTORY SCHIZOPHRENIA

Clozapine has been shown to have superior effectiveness compared with classic neuroleptics in treating refractory schizophrenia in Caucasian s, but its efficacy and safety in Chinese have mot been adequately stu died. Forty Chinese schizophrenic patients were recruited in a 12-week , double-blind, comparative trial. Twenty-one patients were randomly a ssigned to clozapine treatment and 19 to chlorpromazine treatment. The average dose was 543 +/- 157 and 1163 +/- 228 mg/day for clozapine an d chlorpromazine, respectively. The results showed that six clozapine- treated patients (28.6%) had more than 20% improvement in Brief Psychi atric Rating Scale score and were classified as responders, whereas no ne of the chlorpromazine-treated patients was classified as a responde r. The degree of improvement in positive symptoms, negative symptoms a nd Brief Psychiatric Rating Scale scores in the clozapine group was in versely correlated with the severity of negative symptoms at;entry int o the trial. Two clozapine-treated patients were withdrawn from the st udy, one because of leukopenia and nausea, and the other because of vo miting and hypotension. Chlorpromazine treatment was prematurely disco ntinued in two patients, because of jaundice and over sedation in one, and because of severe weight loss in the other (9 kg). The rate of mo derate-to-severe sialorrhea was high in clozapine-treated patients (28 .6%). Two clozapine-treated patients and two chlorpromazine-treated pa tients showed significant improvement in previously existing tardive d yskinesia and one chlorpromazine-treated patient exhibited aggravation of tardive dyskinesia. The results of this study indicate that clozap ine treatment might have advantages over chlorpromazine for Chinese sc hizophrenic patients who are refractory to typical neuroleptic treatme nt.