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• W2261562390 abstract "Psychiatrists know that clozapine helps many patients who have intractable psychotic symptoms that have failed to respond to trials of several antipsychotics. Since dozapine was launched in 1989, miraculous improvements and awakenings have been reported in many patients afflicted with severe schizophrenia and considered hopelessly refractory to antipsychotic pharmacotherapy. Not only do severely disabled patients regain their sanity and return to normal functioning, but the joy that their family and treating psychiatrist experience is priceless. That's why I am perplexed by how infrequently clozapine is used in the United States (in about 5% of patients)--even though approximately 25% of patients who have schizophrenia are either treatment-resistant or have refractory hallucinations or delusions. Consider Bethany's case. She was one of my young patients, who, after taking clozapine, recovered fully and resumed a productive life, after years of homelessness during which she was controlled by auditory hallucinations. Bethany's story began well... Bethany grew up in a loving home, smart and talented, an A student in high school and talented violinist. She received a scholarship to a prestigious private university at 16 and left her parent's home in Ohio to major in molecular biology. Her goal was to attend medical school. She excelled during her first 3 years of college, and even published 2 papers in top-tier science journals. In her senior year, after returning from a trip to Africa, Bethany began to change. She neglected her studies and focused on raising money for HIV clinics in Africa. She began getting F's instead of A's, lost her scholarship and her residence hall room, and had to drop out of college. Soon, she began hearing voices commanding her every action. [ILLUSTRATION OMITTED] ...but took a really bad turn Bethany became homeless for the next 4.5 years. She ate discarded food from garbage cans, had no change of clothes, and slept on a concrete slab behind a downtown church in a major city in California. Her parents lost track of her, although her mother, a retired nurse, frantically and relentlessly tried to find out what happened to her only daughter during that time. Eventually, Bethany was arrested when she was found screaming back at the voices, at midnight in a residential area of the city. She was hospitalized on a psychiatric ward and given antipsychotics, but with only modest improvement. Her parents were contacted; immediately, they flew to California to see her. The treating psychiatrist told them that their daughter had schizophrenia, and that they should lower their expectations because she would be totally disabled for the rest of her life. They brought Bethany back to Ohio where, after a tumultuous year of failed trials of several antipsychotics to suppress the auditory hallucinations, we gave her clozapine. Gradually, Bethany improved, but she still could not read a book or magazine (which I urged her to do) without the voices intensifying and preventing her from reading. [FIGURE 1 OMITTED] Bethany recovers After 6 to 8 months on clozapine, however, Bethany's auditory hallucinations faded away. With my encouragement, she enrolled at the University of Cincinnati and took 1 course at a time. She began to get A's again--in advanced courses, such as genetics, physics, and molecular biology. She completed her degree requirements and graduated with honors, with a Bachelor of Science degree in molecular biology. She also served as a marshal in the commencement ceremony procession. Over the next year, with strong encouragement, Bethany wrote a book about her remarkable recovery from refractory psychosis) In addition, her mother wrote a deeply emotional book that described the gut-wrenching ordeal that she and her husband went through during the years that Bethany disappeared. …" @default.
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• W2261562390 date "2014-10-01" @default.
• W2261562390 modified "2023-09-23" @default.
• W2261562390 title "Clozapine Is a Vastly Underutilized, Unique Agent with Multiple Applications" @default.
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