title: Effectiveness and safety of clozapine in elderly patients with chronic resistant schizophrenia.
abstract: ABSTRACT Background: Recommendations for the treatment of elderly schizophrenia patients are largely based on data extrapolated from studies of antipsychotic medications in younger patient populations. We aimed to evaluate the effectiveness and safety of clozapine monotherapy in a diagnostically homogeneous group of elderly patients suffering from schizophrenia (DSM-IV-TR criteria).
  
  
  METHODS
  A retrospective analysis of computerized medical charts of elderly inpatients suffering from schizophrenia treated at our center during the period January 2007-December 2012 was undertaken. Inclusion criteria were: (1) 60 years and older, (2) unsuccessful treatment with at least three different antipsychotic compounds during the last five years prior to the study period. Mortality and re-hospitalization over a five-year period were the pre-defined outcome measures.
  
  
  RESULTS
  Of 527 elderly patients suffering from schizophrenia 43 patients, mean age 69.4 ± 8.7 years, were treated with clozapine. There were 19 women and 24 men, mean disease duration was 38.8 years. All had been exposed to at least three first- and second-generation antipsychotics prior to clozapine treatment. Clozapine was very well tolerated by the patients and mortality rate (8/43 (18.6% vs. 87/484 (18%)) was equal to that of other first- and second-generation antipsychotics (p < 0.18). Re-hospitalization rates with clozapine were significantly lower than rates for the five-year period prior to exposure to clozapine (0.41 vs. 3.8; p < 0.001).
  
  
  CONCLUSIONS
  The present study demonstrates that clozapine is efficacious and safe for the treatment of elderly schizophrenia patients. Prospective studies are needed to support these findings.
authors.affiliation: Abarbanel Mental Health Center(affiliated with the Sackler Faculty of Medicine,Tel-Aviv University),Bat Yam 59100,Israel.
authors.forename: Shani
authors.initials: S
authors.lastname: Pridan
authors.affiliation: Abarbanel Mental Health Center(affiliated with the Sackler Faculty of Medicine,Tel-Aviv University),Bat Yam 59100,Israel.
authors.forename: Marnina
authors.initials: M
authors.lastname: Swartz
authors.affiliation: Abarbanel Mental Health Center(affiliated with the Sackler Faculty of Medicine,Tel-Aviv University),Bat Yam 59100,Israel.
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Baruch
authors.affiliation: Abarbanel Mental Health Center(affiliated with the Sackler Faculty of Medicine,Tel-Aviv University),Bat Yam 59100,Israel.
authors.forename: Shelly
authors.initials: S
authors.lastname: Tadger
authors.affiliation: Abarbanel Mental Health Center(affiliated with the Sackler Faculty of Medicine,Tel-Aviv University),Bat Yam 59100,Israel.
authors.forename: Igor
authors.initials: I
authors.lastname: Plopski
authors.affiliation: Abarbanel Mental Health Center(affiliated with the Sackler Faculty of Medicine,Tel-Aviv University),Bat Yam 59100,Israel.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Barak
mesh_terms: D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects; D003024:Clozapine / Q000008:administration & dosage / Q000009:adverse effects; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007297:Inpatients; D007557:Israel; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010359:Patient Readmission / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D003024:Clozapine