title: Clozapine treatment of adolescents with posttraumatic stress disorder and psychotic symptoms.
abstract: This study investigates the efficacy of clozapine in treatment-resistant abused adolescents detained in a secure environment who present with chronic posttraumatic stress disorder and psychotic symptoms. All participants had received at least 2 trials of conventional neuroleptic medication prior to starting clozapine. Efficacy was assessed by using single case methodology across 6 participants employing predependent and postdependent measures of psychiatric symptoms and behavioral observations. Subjective self-reports were also sought after treatment had been established. Evaluation of the data suggests that 4 of the participants demonstrated substantial improvements in psychiatric symptoms and behavioral presentation once a therapeutic dose of clozapine had been achieved. Questionnaire responses from 5 participants indicated that clozapine treatment was associated with a reduction in hallucinatory experiences. The most troubling side effects were those of excessive salivation, dizziness, and weight gain. These findings indicate that clozapine may be effective in decreasing psychiatric symptoms and risk behaviors in traumatized adolescents presenting with psychotic symptoms.
authors.affiliation: St. Andrew's Hospital, Northampton, UK. mwheatley@standrew.co.uk
authors.forename: Malcolm
authors.initials: M
authors.lastname: Wheatley
authors.forename: Jo
authors.initials: J
authors.lastname: Plant
authors.forename: Helen
authors.initials: H
authors.lastname: Reader
authors.forename: Geoff
authors.initials: G
authors.lastname: Brown
authors.forename: Caroline
authors.initials: C
authors.lastname: Cahill
mesh_terms: D000293:Adolescent; D000374:Aggression / Q000187:drug effects; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003024:Clozapine / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D012309:Risk-Taking; D016728:Self-Injurious Behavior / Q000188:drug therapy / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000188:drug therapy* / Q000523:psychology
chemical_list: D014150:Antipsychotic Agents; D003024:Clozapine