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KMID : 0361519990100010032
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Korean Journal of Psychopharmacology
1999 Volume.10 No. 1 p.32 ~ p.39
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Therapeutic Predictors of Clozapine Treatment in Patients with Refractory Schizophrenia
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Lee Hong-Shick
Kim Chan-Hyung
Suh Shin-Young
Suh Ho-Suk
Kwon Young-Sam
Chung Tae-Sub
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Abstract
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Objective：The purpose of this study was to identify the predictors of one-year clozapine treatment in refractory schizophrenic patients.
Methods：We defined treatment response as the reduction of total PANSS scores by 20% or more and as the total PANSS scores below 60, or as the CGI severity score below 3, after one-year of clozapine treatment. We compared age, duration of illness, number of hospitalization, plasma monoamine metabolites, ventricle-brain ratio, and short-term treatment response between treatment response group and treatment non-response group.
Results：Among the total patients of 26, 12 (46%) were categorized as treatment response group. In comparing between treatment response group (N＝12) and treatment non-response group (N＝14), there were no differences in age, onset age, duration of illness, but the number of hospitalization was significantly more frequent in treatment non-response group. There was no significant difference in total PANSS scores between the two groups before clozapine treatment. After 4 weeks of clozapine treatment, the changes of PANSS positive score was more higher in treatment response group. The baseline plasma HVA levels and HVA/5-HIAA ratio were significantly higher in treatment response group than in non-response group, but there was no significant difference in baseline plasma 5-HIAA levels between the two groups. No difference existed in ventricle-brain ratio between the two groups.
Conclusion：This study suggests that number of hospitalization and short-term treatment response rate may be useful as the clinical predictors, and that plasma HVA levels also as a biological predictor of long term clozapine treatment.
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KEYWORD
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Clozapine, Refractory schizophrenia, Clozapine, Therapeutic predictors,
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