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Clozapine Treatment of Outpatients With Schizophrenia: Outcome and Long-Term Response Patterns
Alan Breier; Robert W. Buchanan; Donna Irish; William T. Carpenter
Psychiatric Services 1993; doi:
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The authors acknowledge the contributions of Brian Kirkpatrick, M. D., Marlene Shapiro, M. S. W., Pat Ball, B. S. N., and other clinical and research staff of the Maryland Psychiatric Research Center; Diane Brandt, B. S., for data management; Ann Summerfelt and Kevin O'Grady, Ph. D., for statistical consultation; and Jane Hoffmann for secretarial assistance. This work was supported by grants MH45074 and MH40279 from the National Institute of Mental Health.

Maryland Psychiatric Research Center, P. O. Box 21247, Baltimore, Maryland 2 1228; University of Maryland School of Medicine in Baltimore; National Institute of Mental Health in Bethesda, Maryland.

Maryland Psychiatric Research Center, P. O. Box 21247, Baltimore, Maryland 2 1228; University of Maryland School of Medicine in Baltimore

1993 by the American Psychiatric Association

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Abstract

The purpose of the study was to examine the effects of clozapine in treating moderately ill schizophrenic outpatients and to determine the length of medication trial needed to identify responders and nonresponders. Methods: Rates of clinical response, relapses and hospitalizations, and levels of symptomatology and functioning were assessed for 30 chronic schizophrenic outpatients who received clozapine for one year. For some patients, data on relapse and hospitalization during treatment were compared with data from the year before treatment. Results: Eighteen of the 30 patients met criteria for sustained response; 1 7 of the responders were identified within the first four months of treatment. Patients experienced significantly fewer relapses and hospitalizations during treatment than in the previous year. Improvement in positive symptoms, general symptomatology, and levels of functioning reached a plateau during the first six months of treatment and remained at that level during the second six months. Negative symptoms and quality of life showed nonsignificant improvements at 12 months. Conclusions: Results support the use of clozapine in treating chronic, residually symptomatic schizophrenic outpatients. A four-month clozapine trial may be adequate to detect clinical responders in this population.

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