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Time to clozapine response in a standardized trial

1997; American Psychiatric Association; Volume: 154; Issue: 9 Linguagem: Inglês

10.1176/ajp.154.9.1243

1535-7228

Robert R. Conley, William T. Carpenter, Carol A. Tamminga,

Bipolar Disorder and Treatment

Back to table of contents Previous article Next article Full AccessTime to clozapine response in a standardized trialPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.154.9.1243AboutSectionsView articleAbstractPDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View articleAbstractOBJECTIVE: The authors sought to determine the time to clozapine response in treatment-refractory patients with schizophrenia. METHOD: Antipsychotic response to a clozapine trial was examined in 50 treatment-refractory schizophrenic inpatients. Subjects were treated with clozapine for at least 12 months, regardless of response status, according to a standardized, increasing dose protocol. Behavioral changes were measured through monthly assessments with the Brief Psychiatric Rating Scale. RESULTS: Thirty-four subjects (68%) met clinical response criteria by the end of the trial. Response was achieved at a mean dose of 468 mg/day (SD = 168). The dose of 30 (88%) of the responding patients was 600 mg/day or less. The mean time to response was 82 days (SD = 100, range = 10-401). It took an average of 60 days (SD = 87) for subjects to reach the dose at which clozapine response was achieved. Once this dose was reached, the average response time was 17 days (SD = 14, range = 2-56). All 34 subjects who responded met criteria within 8 weeks of a clozapine dose escalation. No late response was found in the remaining 16 subjects despite a mean follow- up period of 75 weeks (SD = 50). CONCLUSIONS: In this study, all patients who responded to clozapine did so within 8 weeks of a change in dose. Thus, there appears to be little clinical gain in prolonging exposure to clozapine beyond 8 weeks at any particular dose if no response is seen. FiguresReferencesCited byDetailsCited ByClinical predictors of response to clozapine in Tunisian patients with treatment resistant schizophreniaComprehensive Psychiatry, Vol. 112Effect of Delayed Clozapine Initiation on Acute Treatment Response in Treatment-Resistant SchizophreniaKorean Journal of Schizophrenia Research, Vol. 24, No. 2A Repeated Time-to-Positive Symptoms Improvement among Malaysian Patients with Schizophrenia Spectrum Disorders Treated with Clozapine22 July 2021 | Pharmaceutics, Vol. 13, No. 8Demographic and clinical variables associated with response to clozapine in schizophrenia: a systematic review and meta-analysis19 February 2021 | Psychological Medicine, Vol. 151Clozapine Response in Schizophrenia and Hematological Changes29 December 2020 | Journal of Clinical Psychopharmacology, Vol. 41, No. 1Demographic and clinical features as predictors of clozapine response in patients with schizophrenia spectrum disorders: A systematic review and meta-analysisNeuroscience & Biobehavioral Reviews, Vol. 111Clozapine augmentation strategiesMental Health Clinician, Vol. 9, No. 6The acute efficacy of antipsychotics in schizophrenia: a review of recent meta-analyses8 October 2018 | Therapeutic Advances in Psychopharmacology, Vol. 8, No. 11Acta Psychiatrica Scandinavica, Vol. 138, No. 5Treatment-Resistant Schizophrenia: Treatment Response and Resistance in Psychosis (TRRIP) Working Group Consensus Guidelines on Diagnosis and TerminologyOliver D. Howes, M.R.C.Psych., Ph.D., Rob McCutcheon, M.R.C.Psych., Ofer Agid, M.D., Andrea de Bartolomeis, M.D., Ph.D., Nico J.M. van Beveren, M.D., Ph.D., Michael L. Birnbaum, M.D., Michael A.P. Bloomfield, M.R.C.Psych., Ph.D., Rodrigo A. Bressan, M.D., Ph.D., Robert W. Buchanan, M.D., William T. Carpenter, M.D., David J. Castle, F.R.C.Psych., Leslie Citrome, M.D., M.P.H., Zafiris J. Daskalakis, M.D., Ph.D., Michael Davidson, M.D., Richard J. Drake, M.R.C.Psych., Ph.D., Serdar Dursun, Ph.D., F.R.C.P.C., Bjørn H. Ebdrup, M.D., Ph.D., Helio Elkis, M.D., Ph.D., Peter Falkai, M.D., Ph.D., W. Wolfgang Fleischacker, M.D., Ary Gadelha, M.D., Ph.D., Fiona Gaughran, M.D., F.R.C.Psych., Birte Y. Glenthøj, M.D., Dr.Med.Sci., Ariel Graff-Guerrero, M.D., Ph.D., Jaime E.C. Hallak, M.D., Ph.D., William G. Honer, M.D., F.R.C.P.C., James Kennedy, M.D., Ph.D., Bruce J. Kinon, M.D., Stephen M. Lawrie, M.D., F.R.C.Psych., Jimmy Lee, M.B.B.S., M.Med., F. Markus Leweke, M.D., James H. MacCabe, F.R.C.Psych., Carolyn B. McNabb, P.G.Dip.Sci., M.H.Sc., Herbert Meltzer, M.D., Hans-Jürgen Möller, M.D., Shinchiro Nakajima, M.D., Ph.D., Christos Pantelis, M.D., M.R.C.Psych., Tiago Reis Marques, M.D., Ph.D., Gary Remington, M.D., Ph.D., Susan L. Rossell, Ph.D., Bruce R. Russell, Ph.D., Cynthia O. Siu, Ph.D., Takefumi Suzuki, M.D., Ph.D., Iris E. Sommer, M.D., Ph.D., David Taylor, Ph.D., Neil Thomas, D.Clin.Psy., Alp Üçok, M.D., Daniel Umbricht, M.D., James T.R. Walters, M.R.C.Psych., Ph.D., John Kane, M.D., Christoph U. Correll, M.D.6 December 2016 | American Journal of Psychiatry, Vol. 174, No. 3The Business Case for Expanded Clozapine UtilizationJessica L. Gören, Pharm.D., Adam J. Rose, M.D., M.Sc., Eric G. Smith, M.D., Ph.D., John P. Ney, M.D., M.P.H.15 June 2016 | Psychiatric Services, Vol. 67, No. 11Subtyping Schizophrenia by Treatment Response: Antipsychotic Development and the Central Role of Positive Symptoms1 November 2015 | The Canadian Journal of Psychiatry, Vol. 60, No. 11Reducing the rates of prescribing high-dose antipsychotics and polypharmacy on psychiatric inpatient and intensive care units: results of a 6-year quality improvement programme9 November 2014 | Therapeutic Advances in Psychopharmacology, Vol. 5, No. 1Expert Opinion on Pharmacotherapy, Vol. 15, No. 16Cochrane Database of Systematic ReviewsActa Neuropsychiatrica, Vol. 25, No. 1A quantitative review of the profile and time course of symptom change in schizophrenia treated with clozapine30 March 2012 | Journal of Psychopharmacology, Vol. 26, No. 9Psychopharmacology, Vol. 224, No. 3European Neuropsychopharmacology, Vol. 22, No. 3Pimozide Augmentation of Clozapine Inpatients with Schizophrenia and Schizoaffective Disorder Unresponsive to Clozapine Monotherapy23 February 2011 | Neuropsychopharmacology, Vol. 36, No. 6Evidence-based guidelines for the pharmacological treatment of schizophrenia: recommendations from the British Association for Psychopharmacology3 February 2011 | Journal of Psychopharmacology, Vol. 25, No. 5Clozapine versus typical neuroleptic medication for schizophrenia21 January 2009 | Cochrane Database of Systematic Reviews, Vol. 160Neuroscience Research, Vol. 64, No. 3Progress in Neuro-Psychopharmacology and Biological Psychiatry, Vol. 33, No. 3Schizophrenia Research, Vol. 109, No. 1-3Clozapine for severe ("kraepelinian") schizophrenia: Sustained improvement over 5 yearsDementia & Neuropsychologia, Vol. 2, No. 1Progress in Neuro-Psychopharmacology and Biological Psychiatry, Vol. 30, No. 2Randomized controlled augmentation trials in clozapine-resistant schizophrenic patients: a critical review16 April 2020 | European Psychiatry, Vol. 20, No. 5-6The World Journal of Biological Psychiatry, Vol. 6, No. 3CNS Drugs, Vol. 19, No. 10Case Studies of Adjunctive Agents in Clozapine-Resistant Schizophrenic PatientsClinical Neuropharmacology, Vol. 28, No. 1Pharmacogenetics of Psychotropic Drug ResponseAnil K. Malhotra, M.D., Greer M. MurphyJr., M.D., Ph.D., and James L. Kennedy, M.D.1 May 2004 | American Journal of Psychiatry, Vol. 161, No. 5Neurotoxicity Research, Vol. 6, No. 1European Archives of Psychiatry and Clinical Neuroscience, Vol. 254, No. 6L'Encéphale, Vol. 30, No. 5Annales Médico-psychologiques, revue psychiatrique, Vol. 162, No. 6CNS Drugs, Vol. 18, No. 9Current Opinion in Psychiatry, Vol. 16Clinical Pharmacokinetics, Vol. 42, No. 7Journal of Psychiatric Practice, Vol. 8, No. 2Unanticipated Plasma Concentrations in Two Clozapine-Treated Patients12 December 2016 | Annals of Pharmacotherapy, Vol. 35, No. 9A statistical model for length of psychiatric in-patient treatment and an analysis of contributing factors9 October 2008 | Acta Psychiatrica Scandinavica, Vol. 103, No. 3The American Psychiatric Association practice guidelines for schizophrenia: Scientific base and relevance for behavior therapyBehavior Therapy, Vol. 32, No. 2Biological Psychiatry, Vol. 50, No. 11Trends in Pharmacological Sciences, Vol. 22, No. 9CNS Spectrums, Vol. 6, No. 12The Pharmacogenomics Journal, Vol. 1, No. 2CNS Drugs, Vol. 13, No. 6Antipsychotic-Induced Weight Gain: A Comprehensive Research SynthesisDavid B. Allison, Ph.D., Janet L. Mentore, M.S.Ed., Moonseong Heo, Ph.D., Linda P. Chandler, Ph.D., Joseph C. Cappelleri, Ph.D., M.P.H., Ming C. Infante, M.S., and Peter J. Weiden, M.D.1 November 1999 | American Journal of Psychiatry, Vol. 156, No. 11Mental Retardation and Developmental Disabilities Research Reviews, Vol. 5, No. 4Biological Psychiatry, Vol. 46, No. 1Progress in Neuro-Psychopharmacology and Biological Psychiatry, Vol. 23, No. 1Progress in Neuro-Psychopharmacology and Biological Psychiatry, Vol. 23, No. 1European Neuropsychopharmacology, Vol. 9, No. 6Current Opinion in Psychiatry, Vol. 12, No. 1Acta Psychiatrica Scandinavica, Vol. 99, No. 4Atypical Antipsychotics Part I: Pharmacology, Pharmacokinetics, and Efficacy28 June 2016 | Annals of Pharmacotherapy, Vol. 33, No. 1Novel Antipsychotics and Patient Care in State Hospitals28 June 2016 | Annals of Pharmacotherapy, Vol. 32, No. 9Olanzapine Compared With Chlorpromazine in Treatment-Resistant SchizophreniaRobert R. Conley, M.D., Carol A. Tamminga, M.D., John J. Bartko, Ph.D., Charles Richardson, M.D., Michael Peszke, M.D., Jami Lingle, Pharm.D., Judith Hegerty, M.D., Raymond Love, Pharm.D., Cathy Gounaris, B.A., and Sandra Zaremba, R.N.1 July 1998 | American Journal of Psychiatry, Vol. 155, No. 7 Volume 154Issue 9 September 1997Pages 1243-1247 Metrics PDF download History Published online 1 April 2006 Published in print 1 September 1997