Therapeutic Predictors of Clozapine Treatment in Patients with Refractory Schizophrenia.
- Author:
Hong Shick LEE
1
;
Chan Hyung KIM
;
Shin Young SEO
;
Ho Suk SUH
;
Young Sam KWON
;
Tae Sub CHUNG
Author Information
1. Department of Psychiatry, Radiology, College of Medicine, Yonsei University, Seoul, Korea. hslee@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Refractory schizophrenia;
Clozapine;
Therapeutic predictors
- MeSH:
Age of Onset;
Clozapine*;
Hospitalization;
Humans;
Hydroxyindoleacetic Acid;
Plasma;
Schizophrenia*
- From:Korean Journal of Psychopharmacology
1999;10(1):32-39
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: The purpose of this study was to identify the predictors of one-year clozapine treatment in refractory schizophrenic patients. METHODS: We defined treatment response as the reduction of total PANSS scores by 20% or more and as the total PANSS scores below 60, or as the CGI severity score below 3, after one-year of clozapine treatment. We compared age, duration of illness, number of hospitalization, plasma monoamine metabolites, ventricle-brain ratio, and short-term treatment response between treatment response group and treatment non-response group. RESULTS: Among the total patients of 26, 12(46%) were categorized as treatment response group. In comparing between treatment response group(N=12) and treatment non-response group (N=14), there were no differences in age, onset age, duration of illness, but the number of hospitalization was significantly more frequent in treatment non-response group. There was no significant difference in total PANSS scores between the two groups before clozapine treatment. After 4 weeks of clozapine treatment, the changes of PANSS positive score was more higher in treatment response group. The baseline plasma HVA levels and HVA/5-HIAA ratio were significantly higher in treatment response group than in non-response group, but there was no significant difference in baseline plasma 5-HIAA levels between the two groups. No difference existed in ventricle-brain ratio between the two groups. CONCLUSION: This study suggests that number of hospitalization and short-term treatment response rate may be useful as the clinical predictors, and that plasma HVA levels also as a biological predictor of long term clozapine treatment.
