Clozapine for Refractory Psychosis

González, Alicia; Michanie, Claudio

doi:10.1097/00004583-199211000-00034

Cited by 7 publications

(2 citation statements)

References 4 publications

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“…Due to concerns of drug-induced agranulocytosis, the use of clozapine has generally been restricted to young patients with recalcitrant treatment conditions ( Table 1) [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Of the available published literature, the most common indication for which clozapine has been studied is treatment-resistant schizophrenia.…”

Section: Clozapinementioning

confidence: 99%

Paediatric uses of atypical antipsychotics

Findling

McNamara

Gracious

2000

Expert Opinion on Pharmacotherapy

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Antipsychotics are commonly prescribed to children and adolescents. With the relatively recent availability of the atypical antipsychotics, physicians have begun prescribing these agents to young people in the hope of finding safe, effective alternatives to the typical antipsychotics. This report reviews what is currently known about the use of the atypical antipsychotics in young people. Most of the currently available data are based on case reports and case series. The results of only a handful of prospective trials pertaining to the use of the atypical antipsychotics in youths have been reported. Based on the available information, it appears that clozapine has a role in juvenile treatment resistant schizophrenia. When considered as a group, the 'first-line' atypical antipsychotics risperidone, olanzapine and quetiapine appear to have promise as treatments for several neuropsychiatric disorders in young people. These conditions include psychotic, mood, disruptive, movement and pervasive developmental disorders. Unfortunately, as has historically been the case, the demand to address the clinical needs of young patients with neuropsychiatric disorders has outpaced empirically based information. This is particularly important because significant side effects can occur when children or adolescents are treated with atypical antipsychotics. Since there is a paucity of short-term and almost no long-term safety data pertaining to these agents in young people, careful consideration must be made prior to initiating atypical antipsychotic treatment for a child or teenager. Based upon what is known about these agents, a rational approach to the use of these drugs in juveniles is offered.

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Section: Clozapinementioning

confidence: 99%

Paediatric uses of atypical antipsychotics

Findling

McNamara

Gracious

2000

Expert Opinion on Pharmacotherapy

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“…Based on the type and severity of the patient's psychotic disorder, one has to decide whether to treat the tumour pharmacologically or surgically. For patients with psychosis and prolactinoma good results can be obtained with pharmacological treatment (Gonzales and Michanie 1992). Surgery in turn should only be used if there is a good probability of removal of the entire tumour.…”

Section: Discussionmentioning

confidence: 99%

Prolactin-secreting pituitary adenoma in neuroleptic treated patients with psychotic disorder

Melkersson

2000

European Archives of Psychiatry and Clinical Neurosciences

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Three patients with psychoses and concomitant prolactin-secreting pituitary tumours are described. Patients A and B had bipolar and schizoaffective disorders, respectively. They had both been treated with neuroleptics for 20 years before the prolactinomas were revealed. Patient C developed a paranoid psychosis after two years of continuous bromocriptine treatment for a pituitary tumour. In patient A the prolactin level was successfully normalized and a good antipsychotic effect was maintained by combined therapy with haloperidol and quinagolide but not bromocriptine. In patient B the prolactinoma was removed by surgery, in view of the serious nature of the psychotic disorder, to avoid psychotic relapse by treatment with a dopamine agonist. In patient C a good result was obtained with the combination of clozapine and bromocriptine. These case reports support the view that neuroleptics being dopamine antagonists and dopamine agonistic agents which are the primary treatment of prolactinomas can cancel out each other's effects. The combination of clozapine and quinagolide is recommended as the treatment of choice for most patients.

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Acute and long-term effectiveness of clozapine in treatment-resistant psychotic depression

Ranjan¹,

Meltzer²

1996

Biological Psychiatry

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Clozapine for Refractory Psychosis

Cited by 7 publications

References 4 publications

Paediatric uses of atypical antipsychotics

Paediatric uses of atypical antipsychotics

Prolactin-secreting pituitary adenoma in neuroleptic treated patients with psychotic disorder

Acute and long-term effectiveness of clozapine in treatment-resistant psychotic depression

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