Clozapine in Severe Conduct Disorder

Teixeira, Eduardo Henrique; Celeri, Eloisa V.; Jacintho, Antonio C. A.; Dalgalarrondo, Paulo

doi:10.1089/cap.2011.0148

Cited by 10 publications

(8 citation statements)

References 13 publications

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“…They showed no significant side effects or hematological changes. The improvement in patterns of aggression in six out of seven patients with severe conduct disorder reinforces previous studies that evaluated clozapine as a treatment for children and adolescents with aggressive behavior for schizophrenia, mental retardation and autism 15,16,21,22). This suggests that clozapine may be useful for reducing aggression in general, not only limited to specific diagnostic groups 16).…”

Section: Introductionsupporting

confidence: 83%

“…The improvement in patterns of aggression in six out of seven patients with severe conduct disorder reinforces previous studies that evaluated clozapine as a treatment for children and adolescents with aggressive behavior for schizophrenia, mental retardation and autism 15,16,21,22). This suggests that clozapine may be useful for reducing aggression in general, not only limited to specific diagnostic groups 16). Clozapine in modest doses appear to have clinical benefits for adolescents with bipolar disorder, intermittent explosive disorder and posttraumatic stress disorder with an off-labeled indication 19)…”

Section: Introductionsupporting

confidence: 82%

“…Subjects’ aggressive scores decreased more than a 50%; therefore, they were considered responders. The secondary endpoints, CBCL and CGAS showed decreased scores also with clinical significance 1,15,16,24,35,36,38,41)…”

Section: Discussionmentioning

confidence: 91%

“…Atypical antipsychotics (risperidone, olanzapine, quetiapine, aripiprazole, clozapine, amisulpiride, sertindole, ziprasidone, zotepine, paliperidone, asenapine and iloperidone) have been used off-label for the treatment of aggression in conduct disorders 1,8–16)…”

Section: Introductionmentioning

confidence: 99%

“…Teixeira et al 15,16). in 2013 reported an open, naturalistic observational study with a sample of 7 boys between 10 and 14 years of age diagnosed with conduct disorder and treated with clozapine.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Clozapine in the Treatment of Aggression in Conduct Disorder in Children and Adolescents: A Randomized, Double-blind, Controlled Trial

Juárez-Treviño

Esquivel

Isida

et al. 2019

Clin Psychopharmacol Neurosci

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ObjectiveThis study was conducted to compare the efficacy of clozapine vs. risperidone in the treatment of aggression in conduct disorder in children and adolescents.MethodsTwenty-four children with conduct disorder aged 6 to 16 years were randomized in a prospective, double-blind trial into two groups to receive clozapine or risperidone for 16 weeks. The Modified Overt Aggression Scale score was used as the primary outcome of the study. Secondary outcomes were Child Behavior Checklist (CBCL) externalization (CBCL-E) and internalization factors; Aggression, Hyperactivity and Delinquency subscales of CBCL-E, Child Global Assessment Scale (CGAS), Barnes Akathisia Rating Scale, and Simpson-Angus Scale.ResultsBoth antipsychotics were similarly effective in the primary outcome and in most of the secondary ones. Clozapine was more effective in CBCL-E, the delinquency subscale and the CGAS scores than risperidone (p=0.039, 0.010, and 0.021). Two subjects from the clozapine group were excluded due to a low neutrophil count at week four.ConclusionClozapine and risperidone are effective for short-term treatment of aggression in children and adolescents with conduct disorder. Clozapine was more effective than risperidone in conduct externalization factors, delinquency trait and global functioning in children and adolescents. Stronger efficacy of clozapine should be investigated in larger sample sizes using pharmacogenomic studies. White blood cell counts need to be monitored when prescribing clozapine.

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Section: Introductionsupporting

confidence: 83%

Section: Introductionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Clozapine in the Treatment of Aggression in Conduct Disorder in Children and Adolescents: A Randomized, Double-blind, Controlled Trial

Juárez-Treviño

Esquivel

Isida

et al. 2019

Clin Psychopharmacol Neurosci

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Atypical antipsychotics for disruptive behaviour disorders in children and youths

Loy

Merry

Hetrick

et al. 2017

Cochrane Database of Systematic Reviews

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Background Disruptive behaviour disorders include conduct disorder, oppositional defiant disorder and disruptive behaviour not otherwise specified. Attention deficit hyperactivity disorder (ADHD) is frequently associated with disruptive behaviour disorders. The difficulties associated with disruptive behaviour disorders are demonstrated through aggression and severe behavioural problems. These often result in presentation to psychiatric services and may be treated with medications such as atypical antipsychotics. There is increasing evidence of a significant rise in the use of atypical antipsychotics for treating disruptive behaviour disorders in child and adolescent populations. Objectives To evaluate the effect and safety of atypical antipsychotics, compared to placebo, for treating disruptive behaviour disorders in children and youths.

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Childhood Enuresis: Current Diagnostic Formulations, Salient Findings, and Effective Treatment Modalities

Thurber¹

2017

Archives of Psychiatric Nursing

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Clozapine in Severe Conduct Disorder

Abstract: We observed good tolerability of clozapine in doses from 100 to 600 mg/day with no significant side effects or hematological changes. The CGI and CBCL 6-18 scales indicated that clozapine led to a marked control of symptoms.

Cited by 10 publications

References 13 publications

Clozapine in the Treatment of Aggression in Conduct Disorder in Children and Adolescents: A Randomized, Double-blind, Controlled Trial

Clozapine in the Treatment of Aggression in Conduct Disorder in Children and Adolescents: A Randomized, Double-blind, Controlled Trial

Atypical antipsychotics for disruptive behaviour disorders in children and youths

Childhood Enuresis: Current Diagnostic Formulations, Salient Findings, and Effective Treatment Modalities

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