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Clozapine Treatment Difficult to Maintain Long Term But Highly Effective When Maintained: Presented at CPA

By Donalee Moulton

HALIFAX, NS -- November 3, 2003 -- The longest follow-up study of clozapine users has confirmed that the atypical antipsychotic drug offers a highly effective treatment option over time, but long-standing compliance is hard to achieve, according to results presented at the 53^rd Annual Meeting of the Canadian Psychiatric Association, held October 30^th to November 2^nd in Halifax, Nova Scotia, Canada.

"Clozapine is a difficult medication but extremely effective," said Panth Voruganti, MD, associate professor, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada. "There is significant impact long term but it is difficult to maintain patients long term."

In this descriptive, cross-sectional study, the researchers conducted clinical assessments in a cohort of schizophrenic outpatients being treated with clozapine and evaluated patients for adverse effects, functional status and quality of life. Participants in the study had been on clozapine, a dibenzodiazepine derivative, for a period of anywhere from five to 13 years.

Study participants were approximately 78% males with a mean age of 42, a treatment duration of 8 years, and were taking an average daily dose of 431 mg of clozapine.

The researchers found significant improvement in patients who were on the antipsychotic drug over time as compared to their pre-clozapine days.

The findings indicated marked functional and behavioural improvement in patients able to maintain a long-term clozapine regimen. Hospitalisation rates decreased noticeably. Study participants had spent a mean of 7.4 days in hospital prior to taking clozapine and 0.99 days post-clozapine. Sixty-two percent were living independently while maintaining a clozapine regimen.

"We're talking about families who had given up hope," said Dr. Voruganti. "The quality of life is dramatically improved [with clozapine]."

He recommended that physicians work closely with patients to try and maintain clozapine treatment where possible.


[Study title: Long-Term Effectiveness of Clozapine Therapy in Treatment – Refractory Schizophrenia: Results of a 5 to 13 Year Follow Up Study. Abstract P1-1]

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