The Effect of Sudden Clozapine Discontinuation on Management of Schizophrenic Patients: A Retrospective Controlled Study.
J Clin Psychiatry 2006;67:1204-1208
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The aims of our study were (1) to
compare the dose of clozapine needed to achieve remission in
patients who stopped their treatment (study group) versus
patients who continued taking this medication (control group) and
(2) to compare the clinical characteristics of remission between
these 2 groups.
Method: We retrospectively reviewed the medical
records of all treatment-resistant schizophrenic and
schizoaffective patients (according to DSM-IV criteria) who were
treated with clozapine over a period of 9 years, from January
1995 through December 2003. The study group consisted of 43
patients and the control group of 12 patients. All patients'
files from both groups were examined, and each patient's
remission was scored twice initially on discharge from the
hospital and subsequently after final discharge for the study
group, or at the end of the study for the control group.
Results: The change of clozapine dose from the
first to the last remission expressed by percentage shows a
significant difference between the 43% increase in clozapine dose
in the study group and the 12.5% decrease in clozapine dose in
the control group (p < .001). Quality of remission assessment
showed deterioration in the global remission score in the study
group, while the quality of remission assessment in the control
group did not show any change.
Conclusions: Our findings suggest that the
discontinuation of clozapine treatment leads to a deterioration
in the quality of remission, with a need for an increased dose of
clozapine. Further prospective studies on larger samples are
needed to confirm these findings.