Current use of clozapine in Parkinson disease and related disorders.
OBJECTIVE
Clozapine has been shown to be effective in the treatment of Parkinson disease psychosis and tremor; however, use of clozapine has been limited because of potential adverse effects and stringent monitoring criteria.


METHODS
To evaluate safety and efficacy in a naturalistic setting, we conducted a retrospective chart review of all patients ever treated with clozapine at a movement disorders clinic in Rhode Island.


RESULTS
Clozapine was indicated for psychosis in 39 patients, for tremor in 19, and for both tremor and psychosis in an additional 6 patients. Fifty of 61 patients reported improvement in their symptoms. Clozapine use was interrupted in 26 patients, for various reasons including transition to hospice care (3), worsening of motor symptoms (4), agranulocytosis (1), intolerable adverse effects (9), symptom resolution (2), and other or unknown reasons (7).


CONCLUSIONS
Clozapine may be useful in the management of movement disorders and related symptoms so long as adequate supervision and monitoring can be provided.
Thomas
Alissa A
AA
Alpert Medical School, Brown University, Providence, RI 02886, USA.
Friedman
Joseph H
JH
D000368:Aged; D000369:Aged, 80 and over; D000380:Agranulocytosis / Q000139:chemically induced; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D001786:Blood Glucose / Q000187:drug effects; D003024:Clozapine / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D020734:Parkinsonian Disorders / Q000188:drug therapy*; D012189:Retrospective Studies; D014202:Tremor / Q000139:chemically induced
D014150:Antipsychotic Agents; D001786:Blood Glucose; D003024:Clozapine