Clinical Predictors of Clozapine Response in Schizophrenics

Kim, Jae Hyung; Suh, Young Dae; Park, Sung Hwa; Chung, Young In

Abstract

The identification of clinical predictors of clozapine response in schizophrenics might be helpful to make a selection of the patients for clozapine treaolent, and could also be useful to diminish the incidence of agranulocytosis, an unpredictable and potentially lethal side effect of clozapine. This study was designed to identify the characteristic symptoms which can predict a good response to clozapine in schizophrenics before or in early stage of clozapine treatmnet. The results were summarized as follows. First, while twenty four patients who had a reduction of 1 point or greater in CGI scores from baseline to six-week clozapine treatment were defined as clozapine responders, seventeen patients without such a change were defined as clozapine nonresponders. The classification between the two groups was assessed to be valid statistically. Second, both baseline BPRS total scores and each score of 6 BPRS items such as anxiety, hostility, hallucinations, bizarre behavior, self-neglect, and excitement were significantly higher in the clozapine responders than in the clozapine nonresponders. Third, in the responders artier the second week of clozapine treatment, there was a significant reduction from baseline on the anxiety and unusual thought content item scores. In conclusion, several symptomatic factors could be regarded as clinical predictors of clozapine response in schizophrenics, including anxiety, hostility, hallucinations, bizarre behavior, self-neglect, and excitement as well as the severity of psychoticism.