Clozapine: current status and role in the pharmacotherapy of schizophrenia.
OBJECTIVE
This study evaluates clozapine and its present role in the pharmacotherapy of schizophrenia.


METHODS
Clozapine's current clinical status is reviewed, as is its position with respect to other treatment options.


RESULTS
Clozapine represents the prototype of "atypical" neuroleptics, with evidence of clinical efficacy in both positive and negative symptoms, as well as a diminished risk of extrapyramidal side effects. It is the only neuroleptic to date that has established itself as having little, if any, risk of tardive dyskinesia. More recent research has focused on its potential for overall savings in health care costs, as well as possible benefits in the area of neuropsychological functioning.


CONCLUSIONS
Evidence suggesting that the course of schizophrenia can be altered by effective treatment favours a systematic approach that optimizes treatment options. While clozapine does not represent a 1st-line agent because of its risk of agranulocytosis, it has an integral role to play in treatment-resistant schizophrenia or in individuals experiencing intolerable side effects with conventional neuroleptics.
Remington
G J
GJ
Department of Psychiatry, University of Toronto, Ontario.
Addington
D
D
Collins
E J
EJ
Jones
B D
BD
Lalonde
P
P
MacCrimmon
D J
DJ
MacEwan
G W
GW
D000380:Agranulocytosis / Q000139:chemically induced; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D003024:Clozapine / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D004409:Dyskinesia, Drug-Induced / Q000191:economics / Q000209:etiology; D006801:Humans; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000188:drug therapy* / Q000191:economics; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D003024:Clozapine