Skip to main content
Erschienen in: CNS Drugs 4/2007

01.04.2007 | Current Opinion

When Should Clozapine Be Initiated in Schizophrenia?

Some Arguments For and Against Earlier Use of Clozapine

verfasst von: Robert Kerwin

Erschienen in: CNS Drugs | Ausgabe 4/2007

Einloggen, um Zugang zu erhalten

Abstract

Clozapine is one of the original atypical antipsychotics. It was withdrawn from the market in 1974 because of haematological safety concerns, but since 1989 has enjoyed a renaissance for the management of treatment-resistant schizophrenia under systems where case registration allows regular haematological monitoring. Clozapine continues to show enduring superiority across many aspects of the clinical pharmacology of the treatment of schizophrenia, e.g. it has specific antisuicidal properties and recent broader trials have shown continuing superiority in wide groups of patients.
This article considers some of the arguments for unshackling clozapine from its current license for schizophrenia (its superiority overall in treatment-resistant schizophrenia, its potential for use in first-episode patients, and its anti-suicidal potential), and tries to synthesise these into some of the national guidelines available for the treatment of schizophrenia.
Literatur
1.
Zurück zum Zitat Baldessarini RJ, Frankenburg FR. Clozapine: a novel agent. N Engl J Med 1991; 324(11): 745–54 Baldessarini RJ, Frankenburg FR. Clozapine: a novel agent. N Engl J Med 1991; 324(11): 745–54
3.
Zurück zum Zitat Idanpaan HJ, Alhave E, Olkinnonora M, et al. Agranulocytosis during treatment with clozapine. Eur J Clin Pharmacol 1977; 11: 94–8 Idanpaan HJ, Alhave E, Olkinnonora M, et al. Agranulocytosis during treatment with clozapine. Eur J Clin Pharmacol 1977; 11: 94–8
4.
Zurück zum Zitat Fitton A, Heel RC. Clozapine: a review of its pharmacological properties and therapeutic use in schizophrenia. Drugs 1990; 40: 722–47PubMedCrossRef Fitton A, Heel RC. Clozapine: a review of its pharmacological properties and therapeutic use in schizophrenia. Drugs 1990; 40: 722–47PubMedCrossRef
5.
Zurück zum Zitat Claghorn J, Honigfield G, Abuzzahab FS. The risks and benefits of clozapine versus chlorpromazine. J Clin Psychopharmacol 1987; 7: 377–84PubMedCrossRef Claghorn J, Honigfield G, Abuzzahab FS. The risks and benefits of clozapine versus chlorpromazine. J Clin Psychopharmacol 1987; 7: 377–84PubMedCrossRef
6.
Zurück zum Zitat Newcomer HJ, Haupt DW. The metabolic effects of antipsychotic medications. Can J Psychol 2006; 51: 480–91 Newcomer HJ, Haupt DW. The metabolic effects of antipsychotic medications. Can J Psychol 2006; 51: 480–91
7.
Zurück zum Zitat Anderman B, Griffith RW. Clozapine induced agranulocytosis: a situation report up to August 1976. Eur J Clin Pharmacol 1977; 11: 199–201PubMedCrossRef Anderman B, Griffith RW. Clozapine induced agranulocytosis: a situation report up to August 1976. Eur J Clin Pharmacol 1977; 11: 199–201PubMedCrossRef
8.
Zurück zum Zitat Altamura AC, Bassetti R, Cattaneo E, et al. Some biological correlates of drug resistance in schizophrenia: a multidimensional approach. World J Biol Psychiatry 2005; 6Suppl. 2: 23–30PubMedCrossRef Altamura AC, Bassetti R, Cattaneo E, et al. Some biological correlates of drug resistance in schizophrenia: a multidimensional approach. World J Biol Psychiatry 2005; 6Suppl. 2: 23–30PubMedCrossRef
9.
Zurück zum Zitat Cole JD, Goldberg SC, Davis JM. Drugs in the treatment of psychosis: controlled studies. In: Solomon P, editor. Psychiatric drugs. New York: Groller and Stratton, 1966: 153–60 Cole JD, Goldberg SC, Davis JM. Drugs in the treatment of psychosis: controlled studies. In: Solomon P, editor. Psychiatric drugs. New York: Groller and Stratton, 1966: 153–60
10.
Zurück zum Zitat Kinon BJ, Kane JM, Johns C, et al. Treatment of neuroleptic resistant schizophrenic relapse. Psychopharmacol Bull 1993; 29: 309–14PubMed Kinon BJ, Kane JM, Johns C, et al. Treatment of neuroleptic resistant schizophrenic relapse. Psychopharmacol Bull 1993; 29: 309–14PubMed
11.
Zurück zum Zitat Kane JM, Honigfeld G, Singer J, et al. Clozapine for the treatment resistant schizophrenic: a double-blind comparison with chlorpromazine. Arch Gen Psychiatry 1988; 45: 789–96PubMedCrossRef Kane JM, Honigfeld G, Singer J, et al. Clozapine for the treatment resistant schizophrenic: a double-blind comparison with chlorpromazine. Arch Gen Psychiatry 1988; 45: 789–96PubMedCrossRef
12.
Zurück zum Zitat Overall JE, Gorham DR. The Brief Psychiatric Rating Scale. Psychol Rep 1962; 10: 799–812CrossRef Overall JE, Gorham DR. The Brief Psychiatric Rating Scale. Psychol Rep 1962; 10: 799–812CrossRef
13.
Zurück zum Zitat Meltzer HY, Bastani B, Young-Kwon H, et al. A prospective study of clozapine in treatment resistant patients: a preliminary report. Psychopharmacology (Berl) 1989; 99Suppl. 68: S68–72CrossRef Meltzer HY, Bastani B, Young-Kwon H, et al. A prospective study of clozapine in treatment resistant patients: a preliminary report. Psychopharmacology (Berl) 1989; 99Suppl. 68: S68–72CrossRef
14.
Zurück zum Zitat Brier A, Buchanan RW, Kirkpatrick B, et al. Effects of clozapine on positive and negative symptoms in outpatients with schizophrenia. Am J Psychiatry 1994; 151(1): 20–6 Brier A, Buchanan RW, Kirkpatrick B, et al. Effects of clozapine on positive and negative symptoms in outpatients with schizophrenia. Am J Psychiatry 1994; 151(1): 20–6
15.
Zurück zum Zitat Kane J, Marder SR, Schooler NR, et al. Efficacy of clozapine versus haloperidol in a long term clinical trial [abstract]. American Psychiatric Association Annual Meeting; 995 May 20–25; Miami (FL) Kane J, Marder SR, Schooler NR, et al. Efficacy of clozapine versus haloperidol in a long term clinical trial [abstract]. American Psychiatric Association Annual Meeting; 995 May 20–25; Miami (FL)
16.
Zurück zum Zitat Lieberman JA, Stroup T, McEvoy JP, et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005; 353: 1209–23PubMedCrossRef Lieberman JA, Stroup T, McEvoy JP, et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005; 353: 1209–23PubMedCrossRef
17.
Zurück zum Zitat Stroup TS, Lieberman JA, McEvoy JP, et al. Effectiveness of olanzapine, quetiapine, risperidone and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic. Am J Psychiatry 2006; 163: 611–22PubMedCrossRef Stroup TS, Lieberman JA, McEvoy JP, et al. Effectiveness of olanzapine, quetiapine, risperidone and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic. Am J Psychiatry 2006; 163: 611–22PubMedCrossRef
18.
Zurück zum Zitat McEvoy JP, Lieberman JA, Stroup TS, et al. Effectiveness of clozapine versus olanzapine, quetiapine and risperidone in patients with schizophrenia who did not respond to prior atypical antipsychotic treatment. Am J Psychiatry 2006; 163: 606–10CrossRef McEvoy JP, Lieberman JA, Stroup TS, et al. Effectiveness of clozapine versus olanzapine, quetiapine and risperidone in patients with schizophrenia who did not respond to prior atypical antipsychotic treatment. Am J Psychiatry 2006; 163: 606–10CrossRef
19.
Zurück zum Zitat Jones PB, Barnes TR, Davies L, et al. Randomized controlled trial of the effect on quality of life of second versus first generation antipsychotic drugs in schizophrenia: Cost Utility of the Latest Antipsychotic drugs in Schizophrenia Study (CUtLASS). Arch Gen Psychiatry 2006; 63: 1079–87PubMedCrossRef Jones PB, Barnes TR, Davies L, et al. Randomized controlled trial of the effect on quality of life of second versus first generation antipsychotic drugs in schizophrenia: Cost Utility of the Latest Antipsychotic drugs in Schizophrenia Study (CUtLASS). Arch Gen Psychiatry 2006; 63: 1079–87PubMedCrossRef
20.
Zurück zum Zitat Lewis SW, Barnes TW, Davies L, et al. Randomized controlled trial of effect of prescription of clozapine versus other second generation antipsychotic drugs in resistant schizophrenia. Schizophrenia Bull 2006; 32: 715–36CrossRef Lewis SW, Barnes TW, Davies L, et al. Randomized controlled trial of effect of prescription of clozapine versus other second generation antipsychotic drugs in resistant schizophrenia. Schizophrenia Bull 2006; 32: 715–36CrossRef
21.
Zurück zum Zitat Munro J, O’Sullivan D, Arana A, et al. Active monitoring of 12,760 clozapine recipients in the UK and Ireland: beyond pharmacovigilance. Br J Psychiatry 1999; 175: 576–80PubMedCrossRef Munro J, O’Sullivan D, Arana A, et al. Active monitoring of 12,760 clozapine recipients in the UK and Ireland: beyond pharmacovigilance. Br J Psychiatry 1999; 175: 576–80PubMedCrossRef
22.
Zurück zum Zitat Walker AM, Lanza LL, Arellano F, et al. Mortality in current and former users of clozapine. Epidemiology 1998; 8: 671–7 Walker AM, Lanza LL, Arellano F, et al. Mortality in current and former users of clozapine. Epidemiology 1998; 8: 671–7
23.
Zurück zum Zitat Atkin K, Kendall F, Gould D, et al. Neutropenia and agranulocytosis in patients receiving clozapine in the UK and Ireland. Br J Psychiatry 1996; 169: 483–8PubMedCrossRef Atkin K, Kendall F, Gould D, et al. Neutropenia and agranulocytosis in patients receiving clozapine in the UK and Ireland. Br J Psychiatry 1996; 169: 483–8PubMedCrossRef
24.
Zurück zum Zitat Honigfeld G, Arellano F, Sethi J, et al. Reducing clozapine related morbidity and mortality: 5 years of experience with the Clozaril National Registry. J Clin Psychiatry 1998; 59Suppl. 3: 3–7PubMed Honigfeld G, Arellano F, Sethi J, et al. Reducing clozapine related morbidity and mortality: 5 years of experience with the Clozaril National Registry. J Clin Psychiatry 1998; 59Suppl. 3: 3–7PubMed
25.
Zurück zum Zitat Bastani B, Alphs LD, Meltzer HG. Development of the Clozaril patient management system. Psychopharmacology (Berl) 1989; 99 Suppl.: S122–5CrossRef Bastani B, Alphs LD, Meltzer HG. Development of the Clozaril patient management system. Psychopharmacology (Berl) 1989; 99 Suppl.: S122–5CrossRef
26.
Zurück zum Zitat Johnstone EC, Crow TJ, Johnson AL, et al. The Northwick Park study of first episodes of schizophrenia: I. Presentation of the illness and problems relating to admission. Br J Psychiatry 1986; 148: 115–20 Johnstone EC, Crow TJ, Johnson AL, et al. The Northwick Park study of first episodes of schizophrenia: I. Presentation of the illness and problems relating to admission. Br J Psychiatry 1986; 148: 115–20
27.
Zurück zum Zitat Crow TJ, MacMillan JF, Johnson AL, et al. Northwick Park study of first episodes of schizophrenia: II. A randomized controlled trial of prophylactic neuroleptic treatment. Br J Psychiatry 1986; 148: 120–7 Crow TJ, MacMillan JF, Johnson AL, et al. Northwick Park study of first episodes of schizophrenia: II. A randomized controlled trial of prophylactic neuroleptic treatment. Br J Psychiatry 1986; 148: 120–7
28.
Zurück zum Zitat Lieberman JA, Jody D, Geisler SH, et al. Time course and biological correlates of treatment response to first episode schizophrenia. Arch Gen Psychiatry 1993; 50: 369–76PubMedCrossRef Lieberman JA, Jody D, Geisler SH, et al. Time course and biological correlates of treatment response to first episode schizophrenia. Arch Gen Psychiatry 1993; 50: 369–76PubMedCrossRef
29.
Zurück zum Zitat Larsen TK, Johannessen JO, Opjordsmoen S. First episode schizophrenia with long duration of psychosis: pathways to care. Brit Journal Psychiatry 1998; 172Suppl. 33: 45–52 Larsen TK, Johannessen JO, Opjordsmoen S. First episode schizophrenia with long duration of psychosis: pathways to care. Brit Journal Psychiatry 1998; 172Suppl. 33: 45–52
30.
Zurück zum Zitat Barnes TRE, Hutton SB, Chapman MJ, et al. West London first episode study of schizophrenia: clinical correlates of duration of untreated psychosis. Br J Psychiatry 2000; 177: 207–11PubMedCrossRef Barnes TRE, Hutton SB, Chapman MJ, et al. West London first episode study of schizophrenia: clinical correlates of duration of untreated psychosis. Br J Psychiatry 2000; 177: 207–11PubMedCrossRef
31.
Zurück zum Zitat Loebel AD, Lieberman JA, Alum JM, et al. Duration of psychosis and outcome in first episode schizophrenia. Am J Psychiatry 1992; 149: 1183–8PubMed Loebel AD, Lieberman JA, Alum JM, et al. Duration of psychosis and outcome in first episode schizophrenia. Am J Psychiatry 1992; 149: 1183–8PubMed
32.
Zurück zum Zitat Perkins DO, Gu K, Boteva K, et al. Relationship between duration of untreated psychosis and outcome in first episode schizophrenia: a critical review and meta-analysis. Am J Psychiatry 2005; 162: 1785–804PubMedCrossRef Perkins DO, Gu K, Boteva K, et al. Relationship between duration of untreated psychosis and outcome in first episode schizophrenia: a critical review and meta-analysis. Am J Psychiatry 2005; 162: 1785–804PubMedCrossRef
33.
Zurück zum Zitat Norman RMG, Lewis SW, Marshall M. Duration of untreated psychosis and its relationship to clinical outcome. Br J Psychiatry 2005; 187: S19–23CrossRef Norman RMG, Lewis SW, Marshall M. Duration of untreated psychosis and its relationship to clinical outcome. Br J Psychiatry 2005; 187: S19–23CrossRef
34.
Zurück zum Zitat Lieberman JA, Tollefson GD, Zipursky CC, et al. Antipsychotic drug effects on brain morphology in first episode psychosis. Arch Gen Psychiatry 2005; 62: 361–76PubMedCrossRef Lieberman JA, Tollefson GD, Zipursky CC, et al. Antipsychotic drug effects on brain morphology in first episode psychosis. Arch Gen Psychiatry 2005; 62: 361–76PubMedCrossRef
35.
Zurück zum Zitat Verdoux H, Bergey C, Assens F, et al. Prediction of duration of psychosis before first admission. Eur Psychiatry 1998; 13: 346–52PubMedCrossRef Verdoux H, Bergey C, Assens F, et al. Prediction of duration of psychosis before first admission. Eur Psychiatry 1998; 13: 346–52PubMedCrossRef
36.
Zurück zum Zitat Lieberman JA, Phillips M, Gu H, et al. Atypical and conventional antipsychotic drugs in treatment naïve first episode schizophrenia: a 52 week randomised trial of clozapine versus chlorpromazine. Neuropsychopharmacology 2003; 28: 995–1003PubMed Lieberman JA, Phillips M, Gu H, et al. Atypical and conventional antipsychotic drugs in treatment naïve first episode schizophrenia: a 52 week randomised trial of clozapine versus chlorpromazine. Neuropsychopharmacology 2003; 28: 995–1003PubMed
37.
Zurück zum Zitat Taylor DM, Young C, Paton C. Prior antipsychotic prescribing in patients currently receiving clozapine: a case note review. J Clin Psychiatry 2003; 64: 30–4PubMedCrossRef Taylor DM, Young C, Paton C. Prior antipsychotic prescribing in patients currently receiving clozapine: a case note review. J Clin Psychiatry 2003; 64: 30–4PubMedCrossRef
38.
Zurück zum Zitat Cohen LJ, Test MA, Brown RL. Suicide and schizophrenia: data from a prospective community treatment study. Am J Psychiatry 1990; 147: 602–7PubMed Cohen LJ, Test MA, Brown RL. Suicide and schizophrenia: data from a prospective community treatment study. Am J Psychiatry 1990; 147: 602–7PubMed
39.
Zurück zum Zitat Nyman A, Jonsson H. Patterns of self destructive behaviour in schizophrenia. Acta Psychiatrica Scandinavica 1986; 73: 252–62PubMedCrossRef Nyman A, Jonsson H. Patterns of self destructive behaviour in schizophrenia. Acta Psychiatrica Scandinavica 1986; 73: 252–62PubMedCrossRef
40.
Zurück zum Zitat Arelsson R, Lagerkuist-Briggs M. Factors predicting suicide in psychotic patients. Eur Arch Psychiatry Clin Neurosci 1992; 241: 259–66CrossRef Arelsson R, Lagerkuist-Briggs M. Factors predicting suicide in psychotic patients. Eur Arch Psychiatry Clin Neurosci 1992; 241: 259–66CrossRef
41.
Zurück zum Zitat Meltzer HY, Okayli G. Reduction of suicidality during clozapine treatment of neuroleptic-resistant schizophrenia: impact on risk benefit assessment. Am J Psychiatry 1995; 152: 183–90PubMed Meltzer HY, Okayli G. Reduction of suicidality during clozapine treatment of neuroleptic-resistant schizophrenia: impact on risk benefit assessment. Am J Psychiatry 1995; 152: 183–90PubMed
42.
Zurück zum Zitat Meltzer HY, Alphs L, Green AI, et al. Clozapine treatment for suicidality in schizophrenia: International Suicide Prevention Trial (InterSePT). N Engl J Med 2003; 60: 82–91 Meltzer HY, Alphs L, Green AI, et al. Clozapine treatment for suicidality in schizophrenia: International Suicide Prevention Trial (InterSePT). N Engl J Med 2003; 60: 82–91
43.
Zurück zum Zitat Alphs L, Anand R, Islam MZ, et al. The International Suicide Prevention Trial (InterSePT): rationale and design of a trial comparing the relative ability of clozapine and olanzapine to reduce suicidal behaviour in schizophrenia and schizophrenic patients. Schizophrenia Bull 2004; 30: 577–86CrossRef Alphs L, Anand R, Islam MZ, et al. The International Suicide Prevention Trial (InterSePT): rationale and design of a trial comparing the relative ability of clozapine and olanzapine to reduce suicidal behaviour in schizophrenia and schizophrenic patients. Schizophrenia Bull 2004; 30: 577–86CrossRef
44.
Zurück zum Zitat Duggan A, Warner J, Knapp M, et al. Modelling the impact of clozapine on suicide in patients with treatment resistant schizophrenia in the UK. Br J Psychiatry 2003; 182: 505–8PubMedCrossRef Duggan A, Warner J, Knapp M, et al. Modelling the impact of clozapine on suicide in patients with treatment resistant schizophrenia in the UK. Br J Psychiatry 2003; 182: 505–8PubMedCrossRef
45.
Zurück zum Zitat Modestin J, Dal Pian D, Argawalla P. Clozapine diminishes suicidal behaviour: a retrospective evaluation of clinical records. J Clin Psychiatry 2005; 66: 534–8PubMedCrossRef Modestin J, Dal Pian D, Argawalla P. Clozapine diminishes suicidal behaviour: a retrospective evaluation of clinical records. J Clin Psychiatry 2005; 66: 534–8PubMedCrossRef
46.
Zurück zum Zitat Sernyak MJ, Hoff R, Rosenheck MD. Clozapine and suicide [letter]. Psychiatric Serv 1999; 50: 116 Sernyak MJ, Hoff R, Rosenheck MD. Clozapine and suicide [letter]. Psychiatric Serv 1999; 50: 116
47.
Zurück zum Zitat Hennen J, Baldessarini RJ. Suicidal risk during treatment with clozapine: a meta analysis. Schizophr Res 2005; 73: 139–45PubMedCrossRef Hennen J, Baldessarini RJ. Suicidal risk during treatment with clozapine: a meta analysis. Schizophr Res 2005; 73: 139–45PubMedCrossRef
48.
Zurück zum Zitat Khan A, Khan SR, Leventhal RM, et al. Symptom reduction and suicide risk among patients treated with placebo in antipsychotic clinical trials: an analysis of the Food and Drug Administration database. Am J Psychiatry 2001; 158: 1449–54PubMedCrossRef Khan A, Khan SR, Leventhal RM, et al. Symptom reduction and suicide risk among patients treated with placebo in antipsychotic clinical trials: an analysis of the Food and Drug Administration database. Am J Psychiatry 2001; 158: 1449–54PubMedCrossRef
49.
Zurück zum Zitat Davis JM, Chen N, Glick ID. A meta analysis of the efficacy of second generation antipsychotics. Arch Gen Psychiatry 2003; 60: 553–64PubMedCrossRef Davis JM, Chen N, Glick ID. A meta analysis of the efficacy of second generation antipsychotics. Arch Gen Psychiatry 2003; 60: 553–64PubMedCrossRef
50.
Zurück zum Zitat Tiihonan J, Wahlbeck K, Lönnqvist J, et al. Effectiveness of antipsychotic treatments in a nationwide cohort of patients in community care after first hospitalisation due to schizophrenia and schizoaffective disorder: observational follow-up study. BMJ 2006; 333(7561): 224. Epub 2006 Jul 6CrossRef Tiihonan J, Wahlbeck K, Lönnqvist J, et al. Effectiveness of antipsychotic treatments in a nationwide cohort of patients in community care after first hospitalisation due to schizophrenia and schizoaffective disorder: observational follow-up study. BMJ 2006; 333(7561): 224. Epub 2006 Jul 6CrossRef
51.
Zurück zum Zitat Angst J, Bente D, Berner P. Das klinische wilkungbild von clozapine. Pharmako-Psychiatrie 1971; 4: 200–11 Angst J, Bente D, Berner P. Das klinische wilkungbild von clozapine. Pharmako-Psychiatrie 1971; 4: 200–11
52.
Zurück zum Zitat Green AI, Schildkraut JJ. Should clozapine be a first line treatment for schizophrenia? The rationale for a double blind clinical trial in first episode patients. Harv Rev Psychiatry 1995; 3: 1–9PubMedCrossRef Green AI, Schildkraut JJ. Should clozapine be a first line treatment for schizophrenia? The rationale for a double blind clinical trial in first episode patients. Harv Rev Psychiatry 1995; 3: 1–9PubMedCrossRef
53.
Zurück zum Zitat Wyatt RJ. Neuroleptics and the natural course of schizophrenia. Schizophr Bull 1991; 17: 325–51PubMedCrossRef Wyatt RJ. Neuroleptics and the natural course of schizophrenia. Schizophr Bull 1991; 17: 325–51PubMedCrossRef
54.
Zurück zum Zitat Woerner G, Robertson DG, Alvil MA, et al. Clozapine as a first treatment for schizophrenia. Am J Psychiatry 2003; 160: 1514–6PubMedCrossRef Woerner G, Robertson DG, Alvil MA, et al. Clozapine as a first treatment for schizophrenia. Am J Psychiatry 2003; 160: 1514–6PubMedCrossRef
55.
Zurück zum Zitat Lieberman JA, Alvil JM, Woerner G, et al. Prospective study of psychobiology in first episode schizophrenia at Hillside Hospital. Schizophr Bull 1992; 18: 351–71PubMedCrossRef Lieberman JA, Alvil JM, Woerner G, et al. Prospective study of psychobiology in first episode schizophrenia at Hillside Hospital. Schizophr Bull 1992; 18: 351–71PubMedCrossRef
56.
Zurück zum Zitat Kelly DL, Conley RR, Carpenter WT. First episode schizophrenia: a focus on pharmacological treatment and safety considerations. Drugs 2005; 65: 1113–38PubMedCrossRef Kelly DL, Conley RR, Carpenter WT. First episode schizophrenia: a focus on pharmacological treatment and safety considerations. Drugs 2005; 65: 1113–38PubMedCrossRef
57.
Zurück zum Zitat Hofer A, Hummer M, Kemmier G, et al. The safety of clozapine in the treatment of first and multiple episode patients with treatment resistant schizophrenia. Int J Neuropsychopharmacology 2003; 6: 201–6CrossRef Hofer A, Hummer M, Kemmier G, et al. The safety of clozapine in the treatment of first and multiple episode patients with treatment resistant schizophrenia. Int J Neuropsychopharmacology 2003; 6: 201–6CrossRef
58.
Zurück zum Zitat Wang PS, Ganz DA, Benner JS, et al. Should clozapine continue to be restricted to third line status for schizophrenia: a decision analytic model. J Ment Health Policy Econ 2004; 7: 77–85PubMed Wang PS, Ganz DA, Benner JS, et al. Should clozapine continue to be restricted to third line status for schizophrenia: a decision analytic model. J Ment Health Policy Econ 2004; 7: 77–85PubMed
59.
Zurück zum Zitat National Institute for Healthcare and Clinical Excellence (NICE): Guidance on the use of newer (atypical) antipsychotic drugs for the treatment of schizophrenia. Technology Appraisal no. 43, 2002 [online]. Available from URL: http://www.nice.org.uk [Accessed 2006 Dec 18] National Institute for Healthcare and Clinical Excellence (NICE): Guidance on the use of newer (atypical) antipsychotic drugs for the treatment of schizophrenia. Technology Appraisal no. 43, 2002 [online]. Available from URL: http://​www.​nice.​org.​uk [Accessed 2006 Dec 18]
60.
Zurück zum Zitat Royal Australian and New Zealand College of Psychiatrists. Clinical practice guidelines for the treatment of schizophrenia and related disorders. Aust N Z J Psychiatry 2005; 39: 1–30CrossRef Royal Australian and New Zealand College of Psychiatrists. Clinical practice guidelines for the treatment of schizophrenia and related disorders. Aust N Z J Psychiatry 2005; 39: 1–30CrossRef
61.
Zurück zum Zitat American Psychiatric Association. Practice guidelines for the treatment of patients with schizophrenia. 2nd draft. Washington, DC: American Psychiatric Association, 2003 American Psychiatric Association. Practice guidelines for the treatment of patients with schizophrenia. 2nd draft. Washington, DC: American Psychiatric Association, 2003
Metadaten
Titel
When Should Clozapine Be Initiated in Schizophrenia?
Some Arguments For and Against Earlier Use of Clozapine
verfasst von
Robert Kerwin
Publikationsdatum
01.04.2007
Verlag
Springer International Publishing
Erschienen in
CNS Drugs / Ausgabe 4/2007
Print ISSN: 1172-7047
Elektronische ISSN: 1179-1934
DOI
https://doi.org/10.2165/00023210-200721040-00002

Weitere Artikel der Ausgabe 4/2007

CNS Drugs 4/2007 Zur Ausgabe

Adis Drug Evaluation

Sodium Oxybate

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Thrombektomie auch bei großen Infarkten von Vorteil

16.05.2024 Ischämischer Schlaganfall Nachrichten

Auch ein sehr ausgedehnter ischämischer Schlaganfall scheint an sich kein Grund zu sein, von einer mechanischen Thrombektomie abzusehen. Dafür spricht die LASTE-Studie, an der Patienten und Patientinnen mit einem ASPECTS von maximal 5 beteiligt waren.

Schwindelursache: Massagepistole lässt Otholiten tanzen

14.05.2024 Benigner Lagerungsschwindel Nachrichten

Wenn jüngere Menschen über ständig rezidivierenden Lagerungsschwindel klagen, könnte eine Massagepistole der Auslöser sein. In JAMA Otolaryngology warnt ein Team vor der Anwendung hochpotenter Geräte im Bereich des Nackens.

Schützt Olivenöl vor dem Tod durch Demenz?

10.05.2024 Morbus Alzheimer Nachrichten

Konsumieren Menschen täglich 7 Gramm Olivenöl, ist ihr Risiko, an einer Demenz zu sterben, um mehr als ein Viertel reduziert – und dies weitgehend unabhängig von ihrer sonstigen Ernährung. Dafür sprechen Auswertungen zweier großer US-Studien.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.