Compulsory treatment with clozapine: a retrospective long-term cohort study.
BACKGROUND
Clozapine is the gold standard in treatment of treatment-resistant psychotic patients. We know little about the effects of compulsory treatment in patients unwilling to accept the necessary treatment.


OBJECTIVE
To assess the effectiveness, tolerability and safety of compulsory treatment with clozapine (CTC).


METHODS
A cohort of 17 consecutive patients given compulsory treatment with clozapine were rated retrospectively by their treating psychiatrists on the basis of their case notes.


RESULTS
CGI-S decreased significantly over time until last observation after a mean of more than 15 months. No patient deteriorated as measured by CGI-I. At last observation as many as ten of the 11 patients still on clozapine were classified as much to very much improved. The degree of custodial restriction at last observation showed improvement in 11 patients and no change in six. No serious adverse events were observed.


CONCLUSIONS
A trial of compulsory treatment with clozapine showed this treatment to be feasible, effective, safe and well tolerated.
Schulte
Peter F J
PF
Department De Dijk, Mental Health Services North-Holland North, Kennemerstraatweg 464, 1851 NG Heiloo, The Netherlands. r.schulte@ggz-nhn.nl
Stienen
Juan J
JJ
Bogers
Jan
J
Cohen
Dan
D
van Dijk
Daniel
D
Lionarons
Wendell H
WH
Sanders
Sophia S
SS
Heck
Adolph H
AH
D000328:Adult; D003024:Clozapine / Q000627:therapeutic use*; D003068:Coercion; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy; D008875:Middle Aged; D009426:Netherlands; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D003024:Clozapine