title: Clozapine impact on clinical outcomes and aggression in severely ill adolescents with childhood-onset schizophrenia.
abstract: OBJECTIVE
  To evaluate the impact of clozapine on aggressive behaviour and clinical outcomes in children and adolescents with schizophrenia or schizoaffective disorder.
  
  
  METHODS
  We reviewed the charts of 6 children and adolescents who were admitted consecutively to a long-term care facility for clinical outcomes, including seclusion and restraints incidents prior to and during clozapine treatment. We also present a representative case history.
  
  
  RESULTS
  We noted clinically significant improvements in social interaction and decreases in the number of violent episodes and homicidal or suicidal thoughts. The global assessment of functioning (GAF) scores improved significantly. Weight gain was significant.
  
  
  CONCLUSIONS
  These cases illustrate the benefits of clozapine treatment in refractory childhood-onset schizophrenia. Outcomes are similar to those described in adults. Even though open data limit conclusions from this study, it is pertinent that there was a clinically significant improvement in aggressive behaviours. This may be particularly important for improved morale of patients, their families, and treating staff. It may also be helpful in discharge to a less restrictive environment.
authors.affiliation: Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Mayview State Hospital, Pittsburgh, Pennsylvania, USA.
authors.forename: L
authors.initials: L
authors.lastname: Chalasani
authors.forename: R
authors.initials: R
authors.lastname: Kant
authors.forename: K N
authors.initials: KN
authors.lastname: Chengappa
mesh_terms: D000293:Adolescent; D000374:Aggression / Q000187:drug effects*; D003024:Clozapine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D010343:Patient Admission; D011569:Psychiatric Status Rating Scales; D012561:Schizophrenia, Childhood / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects
chemical_list: D003024:Clozapine