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• W36634213 abstract "Back to table of contents Previous article Next article No AccessPatient response and resource management: another view of clozapine treatment of schizophreniaPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.152.6.827AboutSectionsView articleAbstractPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View articleAbstractOBJECTIVE: Issues in clozapine treatment were considered in terms of implications for resource management. METHOD: A critical review of the literature on time course and pattern of response to clozapine was used to address treatment of negative symptoms, late responders, and extent of clinical benefit in ordinary settings. RESULTS: Superior efficacy of clozapine for partial and poor neuroleptic responders is observed in about one-half of the cases. Response is rapid once a therapeutic dose is reached, and the data do not support the proposition that some patients first respond only after 3-12 months of therapy. The cumulative benefit over several months of treatment and the broad range of symptoms involved in response are similar to those for typical neuroleptic drugs, suggesting that clozapine's superiority is based on greater effectiveness rather than a unique profile of treatment effects. Clozapine appears to be effective for secondary, but not primary, negative symptoms. Modal response is moderate, and extensive rehabilitation and clinical services are required to substantially enhance functional outcome. CONCLUSIONS: Many more patients merit trials with clozapine. Economic costs and adverse drug effects can be minimized by selecting patients most likely to benefit and discontinuing clozapine treatment when benefit is not observed within 2- 4 months. Appropriate patients include 1) those with good responses to typical neuroleptics who experience substantial adverse effects and 2) those whose disorders respond poorly to standard neuroleptics and are defined by psychotic symptoms, thought disorder, and hostility. Treatment of primary negative symptoms is not supported by the current experimental data. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byCultural Considerations for Schizophrenia Spectrum Disorders Part I: Symptoms, Diagnosis, and Prevalence9 February 2020Serotonin and schizophreniaClozapine augmentation strategiesMental Health Clinician, Vol. 9, No. 6Clozapine and Psychosocial Function in Schizophrenia: A Systematic Review and Meta-Analysis28 August 2018 | CNS Drugs, Vol. 32, No. 11What Can We Do If Clozapine Fails? Pharmacologic Choices and Differential Outcomes28 January 2014PLoS ONE, Vol. 8, No. 6European Neuropsychopharmacology, Vol. 22, No. 3Clinical Schizophrenia & Related Psychoses, Vol. 6, No. 3Clinical Psychopharmacology and Neuroscience, Vol. 10, No. 2Clozapine Use in Schizophrenia: Findings of the Research on Asia Psychotropic Prescription (REAP) Studies from 2001 to 20091 November 2011 | Australian & New Zealand Journal of Psychiatry, Vol. 45, No. 11Sex Differences in Use of Psychotropic Drugs and Drug-Induced Side Effects in Schizophrenia Patients: Findings of the Research on Asia Psychotropic Prescription (REAP) Studies1 March 2011 | Australian & New Zealand Journal of Psychiatry, Vol. 45, No. 3Klinik Psikofarmakoloji Bülteni-Bulletin of Clinical Psychopharmacology, Vol. 21, No. 2A Post Hoc Analysis of Negative Symptoms and Psychosocial Function in Patients With SchizophreniaJournal of Clinical Psychopharmacology, Vol. 30, No. 4, Vol. 21Psiquiatría Biológica, Vol. 17, No. 3Hemoperfusion in the Treatment of Acute Clozapine Intoxication in ChinaJournal of Clinical Psychopharmacology, Vol. 27, No. 6Human Psychopharmacology: Clinical and Experimental, Vol. 22, No. 1Progress in Neuro-Psychopharmacology and Biological Psychiatry, Vol. 31, No. 2Psychiatric Clinics of North America, Vol. 30, No. 3Acta Psychiatrica Scandinavica, Vol. 115, No. 2The Schizophrenia ParadigmJournal of Nervous & Mental Disease, Vol. 194, No. 9Effectiveness of Clozapine Versus Olanzapine, Quetiapine, and Risperidone in Patients With Chronic Schizophrenia Who Did Not Respond to Prior Atypical Antipsychotic TreatmentJoseph P. 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Kelley, M.S., Daniel P. van Kammen, M.D., Ph.D., and Daniel N. Allen, Ph.D.1 March 1999 | American Journal of Psychiatry, Vol. 156, No. 3Clozapine and Risperidone in Chronic Schizophrenia: Effects on Symptoms, Parkinsonian Side Effects, and Neuroendocrine ResponseAlan F. Breier, M.D., Anil K. Malhotra, M.D., Tung-Ping Su, M.D., Debra A. Pinals, M.D., Igor Elman, M.D., Caleb M. Adler, M.D., R. 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CarpenterJr., M.D.1 June 1998 | American Journal of Psychiatry, Vol. 155, No. 6Risperidone Versus Clozapine in Treatment-Resistant Chronic Schizophrenia: A Randomized Double-Blind StudyG. Bondolfi, M.D., H. Dufour, M.D., M. Patris, M.D., J. P. May, M.D., U. Billeter, M.D., C. B. Eap, Ph.D., and P. Baumann, Ph.D., on Behalf of the Risperidone Study Group1 April 1998 | American Journal of Psychiatry, Vol. 155, No. 4Medical Complications and Selectivity of Therapeutic Response to Atypical Antipsychotic DrugsDiana O. Perkins, M.D., M.P.H., and Jeffrey A. 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