Outcome of clozapine therapy for elderly patients with refractoryprimary psychosis
M. Sajatovic
Bok Engelsk 1997
| Utgitt | 1997
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| Omfang | Side 553- 558
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| Opplysninger | Objective. The objective was to analyze outcome of clozapine therapyin elderly patients with treatment refractory primary psychosis.Design. This was an open-label clozapine trial in elderly patients.Patient psychopathology was assessed before and after clozapinetherapy.Setting. A psychiatry service at a large urban/suburban VeteransAdministration Medical Center.Patients. Inpatients and outpatients age 65 years or older withprimary psychotic disorders established to be resistant toconventional antipsychotic therapy (Kane et al., 1988). Ten patientsmet study inclusion criteria out of a total of 134 patients receivingclozapine at the Cleveland VAMC (7.5%). Mean age of the group was70.6 years.Measures. Patients were rated with the Brief Psychiatric Rating Scale(BPRS; Overall and Gorham, 1962). Additional data on patientdemographics, comorbid non-psychiatric diagnoses and concurrentpsychotropic medication were collected via chart review.Results. Mean clozapine dosage was 204 mg/day for a mean duration of430 days. 7/10 patients had some degree of clinical improvement and3/10 patients had significant improvement documented by BPRS changeof 20% or greater. Patients had a mean of 1.4 comorbid physicalillnesses, which were not worsened by clozapine therapy. 4/10patients discontinued clozapine therapy due to adverse effects orinability to comply with bloodwork; however, only 2/10 were trulytreatment intolerant.Conclusions. Clozapine is a useful alternative treatment option forelderly individuals with refractory primary psychosis. As in youngerpatients, inability to tolerate drug-related adverse effects orweekly bloodwork may lead to drug discontinuation. (C) 1997 by JohnWiley & Sons, Ltd.
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