An open trial of clozapine in neuroleptic-resistant childhood-onset schizophrenia.
BACKGROUND
Studies performed with schizophrenic adults who were resistant to classical neuroleptics showed improvement in 30% of the patients when treated with clozapine. Very early onset schizophrenic patients benefit only partially from conventional antipsychotics and are at increased risk of developing extrapyramidal symptoms; clozapine may offer an alternative treatment for these patients.


METHODS
Eleven neuroleptic-resistant children (< 13 years) with schizophrenia were treated with clozapine. Improvement was monitored during the first 16 weeks using the Brief Psychiatric Rating Scale, Positive and Negative Syndrome Scale and Clinical Global Impression. The mean clozapine dosage was 227.3 (s.d. 34.4 mg/day at the end of the 16 weeks.


RESULTS
There was an overall statistically significant reduction in all parameters, especially positive symptoms, implying a favourable outcome. Most of the improvement occurred during the first 6 to 8 weeks. The major side-effects were somnolence and drooling (no agranulocytosis).


CONCLUSIONS
Clozapine may be a promising drug for the treatment of resistant childhood-onset schizophrenia.
Turetz
M
M
Child and Adolescent Outpatient Clinic, Ness Ziona Mental Health Center, Israel.
Mozes
T
T
Toren
P
P
Chernauzan
N
N
Yoran-Hegesh
R
R
Mester
R
R
Wittenberg
N
N
Tyano
S
S
Weizman
A
A
D000293:Adolescent; D017668:Age of Onset; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D003024:Clozapine / Q000009:adverse effects / Q000627:therapeutic use*; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D012561:Schizophrenia, Childhood / Q000188:drug therapy*; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D003024:Clozapine