Citation

Casey DE. J. Clin. Psychiatry 1998; 59 Suppl 3: 31-37.

Copyright

(Copyright © 1998, Physicians Postgraduate Press)

DOI

unavailable

PMID

9541336

Abstract

Neuroleptics were the first modern class of pharmacotherapeutic agents available for the treatment of schizophrenia. Although they were effective in reducing florid psychotic symptoms, up to 90% of treated individuals subsequently developed extrapyramidal symptoms (EPS) (akathisia, dystonia, or parkinsonism), and about 20% developed tardive dyskinesia (TD). When clozapine became commercially available for treatment-resistant and treatment-intolerant (i.e., prone to EPS and TD) schizophrenic individuals, it became apparent that an antipsychotic need not induce motor side effects to be efficacious in reducing the symptomatology of schizophrenia. Sociodemographic, behavioral, and clinical predictors of TD are useful in identifying a subset of schizophrenic individuals who would benefit from treatment with clozapine, the prototype atypical antipsychotic whose efficacy and motor side effect profile are superior to those of chlorpromazine. This favorable motor side effect profile of clozapine contributes to improved patient outcomes by reducing noncompliance, substance abuse, and suicide, resulting in improved quality of life and savings on health care costs.

Language: en

Keywords

Age Factors; Aged; Basal Ganglia Diseases; Clozapine; Dyskinesia, Drug-Induced; Female; Humans; Male; Middle Aged; Prevalence; Risk Factors; Schizophrenia; Substance-Related Disorders; Suicide; Suicide Prevention; Treatment Outcome; Treatment Refusal