SPECT study of regional cerebral perfusion in neuroleptic-resistant schizophrenic patients who responded or did not respond to clozapine.
OBJECTIVE
The purpose of this study was to find predictive criteria for response to clozapine.


METHODS
Single photon emission computed tomography studies of cerebral perfusion were done in 24 treatment-resistant schizophrenic patients while they were taking typical neuroleptics and again after they had been treated with clozapine for 6 months. Perfusion ratios of the subjects categorized as responders or nonresponders to clozapine and of the subjects in the two treatment conditions were compared. The ratios with significant between-group differences were compared to those from a normal database.


RESULTS
Before clozapine, while taking neuroleptics, subjects who became responders to clozapine showed higher thalamic, left basal ganglia, and right prefrontal perfusion. Nonresponders to clozapine had lower prefrontal perfusion and responders had higher subcortical perfusion than subjects in the normal database. The subcortical perfusion of the responders decreased when they received clozapine.


CONCLUSIONS
The study of cerebral perfusion may contribute to the prediction of response to clozapine.
Molina Rodríguez
V
V
Department of Psychiatry, Centro San Juan de Dios, Ciempozuclos, Madrid, Spain.
Montz Andreé
R
R
Pérez Castejón
M J
MJ
Capdevila García
E
E
Carreras Delgado
J L
JL
Rubia Vila
F J
FJ
D000328:Adult; D014150:Antipsychotic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001479:Basal Ganglia / Q000098:blood supply; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation / Q000187:drug effects; D003024:Clozapine / Q000494:pharmacology / Q000627:therapeutic use*; D004351:Drug Resistance; D007839:Functional Laterality; D006801:Humans; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000098:blood supply; D011336:Probability; D012563:Schizophrenia, Paranoid / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013788:Thalamus / Q000098:blood supply; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D003024:Clozapine