title: Clozapine: its impact on aggressive behavior among children and adolescents with schizophrenia.
abstract: OBJECTIVE
  To evaluate the effectiveness of clozapine on aggressive behavior for treatment-refractory adolescents (age range 8.5-18) with schizophrenia (295.x) at Bronx Children's Psychiatric Center.
  
  
  METHODS
  Clozapine treatment was administered in an open-label fashion using a flexible titration schedule. The frequency of administration of emergency oral and injectable medications and the frequency of seclusion events 3 months immediately before and from 12 to 24 weeks of clozapine treatment (when optimal clozapine levels were achieved) were compared.
  
  
  RESULTS
  Twenty clozapine-treated children (mean +/- SD dose at week 24, 476 +/- 119 mg) were included. A statistically significant decrease in the frequency of the administration of emergency oral medications, the administration of emergency injectable medications, and seclusion events was found in adolescents during weeks 12 to 24 of clozapine treatment compared with their baseline condition before clozapine initiation.
  
  
  CONCLUSIONS
  These preliminary data indicate the benefits of clozapine treatment in adolescents with treatment-refractory schizophrenia for aggressive behaviors. Although open data limit conclusions from this study, it is important that there was a clinically significant improvement in aggressive behaviors that enabled patients to be discharged to a less restrictive setting. Additional controlled clinical trials of clozapine are needed in treatment-refractory children and adolescents.
authors.affiliation: Bronx Children's Psychiatric Center, Department of Psychiatry, Albert Einstein College of Medicine, Bronx, USA.
authors.forename: Harvey
authors.initials: H
authors.lastname: Kranzler
authors.forename: David
authors.initials: D
authors.lastname: Roofeh
authors.forename: Ginny
authors.initials: G
authors.lastname: Gerbino-Rosen
authors.forename: Carolyn
authors.initials: C
authors.lastname: Dombrowski
authors.forename: Marjorie
authors.initials: M
authors.lastname: McMeniman
authors.forename: Courtney
authors.initials: C
authors.lastname: DeThomas
authors.forename: Anne
authors.initials: A
authors.lastname: Frederickson
authors.forename: Laurie
authors.initials: L
authors.lastname: Nusser
authors.forename: Mark D
authors.initials: MD
authors.lastname: Bienstock
authors.forename: Gene S
authors.initials: GS
authors.lastname: Fisch
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Kumra
mesh_terms: D000293:Adolescent; D000374:Aggression / Q000523:psychology*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002648:Child; D003024:Clozapine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology
chemical_list: D014150:Antipsychotic Agents; D003024:Clozapine