The efficacy and safety of clozapine versus chlorpromazine in geriatric schizophrenia
| Autor: | Norman Eisenstein, David A. Smelson, M Pardo, Charles Engelhart, E. Howanitz, Miklos F. Losonczy, R G Stern |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
medicine.medical_specialty
Psychosis Side effect Chlorpromazine Population Weight Gain Double-Blind Method Internal medicine medicine Humans Psychiatry education Clozapine Aged Psychiatric Status Rating Scales education.field_of_study Positive and Negative Syndrome Scale Intestinal Pseudo-Obstruction Age Factors medicine.disease Psychiatry and Mental health Treatment Outcome Tolerability Schizophrenia Schizophrenic Psychology Psychology medicine.drug Agranulocytosis Antipsychotic Agents |
| Zdroj: | The Journal of clinical psychiatry. 60(1) |
| ISSN: | 0160-6689 |
| Popis: | Background There has been an absence of controlled studies focusing specifically on neuroleptic treatment in the elderly schizophrenic population. Therefore, we conducted a 12-week double-blind comparison study to assess the efficacy and tolerability of clozapine and chlorpromazine in a group of elderly inpatients with chronic schizophrenia. Method Forty-two elderly DSM-IV schizophrenic veterans were randomly assigned to clozapine or chlorpromazine and assessed for efficacy at baseline and at termination with the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impressions scale (CGI). Side effects were also monitored. Medications were titrated, on the basis of clinical response and side effects, to a maximum dose of 300 mg/day of clozapine or 600 mg/day of chlorpromazine. Results The results suggest that both the chlorpromazine and clozapine groups improved their PANSS scores at termination compared with baseline, but the difference between the 2 groups was not statistically significant. The mean CGI scores reflecting severity of illness also demonstrated improvement in both groups over time. Both groups had similar incidences of side effects. One patient in each group had a life-threatening side effect. More patients taking clozapine had tachycardia and weight gain, while more chlorpromazine patients noted sedation. Conclusion We concluded that both clozapine and chlorpromazine are effective treatments for psychosis and behavioral disturbances in geriatric schizophrenia. Both agents had similar incidences of side effects. With careful monitoring and titration of dosage, both clozapine and chlorpromazine were fairly well tolerated in this population. |
| Databáze: | OpenAIRE |
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