18-month outcome of clozapine treatment for 100 patients in a state psychiatric hospital.
OBJECTIVE
The atypical antipsychotic medication clozapine is an effective treatment for refractory psychosis; however, the efficacy of clozapine when used in public mental health programs has yet to be fully characterized. This study assessed the outcome of clozapine treatment in a state hospital.


METHODS
The medical records of the first 100 patients to receive clozapine in a state hospital, from six months before clozapine treatment through 18 months of treatment, were reviewed.


RESULTS
The patients had chronic psychotic disorders that had responded poorly to treatment with conventional antipsychotic medication. Eighteen months after beginning clozapine, 45 patients were much improved, and 18 were somewhat improved. All except one of the improved patients were continuing clozapine treatment. Forty patients were living in community settings, 59 remained hospitalized, and one had died of an illness unrelated to clozapine. Violent episodes in the hospital decreased during the first six months of clozapine treatment. Thirteen patients had one or two seizures while taking clozapine, 12 of whom successfully continued clozapine treatment. One patient developed agranulocytosis, and one developed leucopenia; each recovered fully after clozapine treatment was discontinued.


CONCLUSIONS
Clozapine was an effective treatment for refractory psychotic disorders when given as a part of routine state hospital treatment.
Wilson
W H
WH
Oregon Health Sciences University, Portland 97201, USA.
Claussen
A M
AM
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D003024:Clozapine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006778:Hospitals, Psychiatric; D006783:Hospitals, State; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000523:psychology; D012917:Social Adjustment; D016896:Treatment Outcome
D003024:Clozapine