The Risks and Benefits of Clozapine versus Chlorpromazine

Claghorn, James L.; Honigfeld, Gilbert; Abuzzahab, F. S.; Wang, Thomas J.; Steinbook, Richard M.; Tuason, V.B.; Klerman, Gerald L.

doi:10.1097/00004714-198712000-00002

Cited by 277 publications

(106 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our study design does not fully exclude a time effect on clozapine response, but the data seen here would discourage longduration trials that search for late response, unless the length of the trial is dictated by a slow dose-escalation time. This recommendation is consistent with the findings from other naturalistic follow-up studies of clozapine (10,11,15,23,24). Prolonged trials should be justified by other clinical factors, such as improved drug tolerance or a lessening of side effects with clozapine.…”

Section: Discussionsupporting

confidence: 85%

“…A relative indication for a clozapine trial may be persistent hostility in a chronically psychotic individual. Poor subjective experience on prior drug treatment has also been associated with clozapine response (11,15,21). Although we did not rate prior drug experience in this group, patients with high baseline anxiety-depression scores were likely to have had poor experiences or more side effects during prior drug treatment.…”

Section: Discussionmentioning

confidence: 89%

See 1 more Smart Citation

Time to clozapine response in a standardized trial

Conley

Carpenter

Tamminga

1997

AJP

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 89%

Time to clozapine response in a standardized trial

Conley

Carpenter

Tamminga

1997

AJP

View full text Add to dashboard Cite

“…Sensitivity analysis that removed studies with more than 25% attrition (Chiu 1976 (44%), 78 Guirguis 1977 (30%), 79 Honigfeld 1984 (29%), 88 Claghorn 1987 (42%), 98 Marder 1994 (46%), 116 Essock 1996 (46%) 103 ) made no substantial differences to the short-to medium-term results but left no long-term data, which suggests that all long-term results should be treated with caution.…”

Section: Sensitivity Analysesmentioning

confidence: 99%

A systematic review of atypical antipsychotic drugs in schizophrenia

Bagnall

Jones

Ginnelly

et al. 2003

Health Technol Assess

151

114

View full text Add to dashboard Cite

Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTAA systematic review of atypical antipsychotic drugs in schizophrenia NHS R&D HTA ProgrammeT he NHS R&D Health Technology Assessment (HTA) Programme was set up in 1993 to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS.The research reported in this monograph was commissioned by the HTA Programme on behalf of the National Institute for Clinical Excellence (NICE). Technology assessment reports are completed in a limited time to inform the appraisal and guidance development processes managed by NICE. The review brings together evidence on key aspects of the use of the technology concerned. However, appraisals and guidance produced by NICE are informed by a wide range of sources.The research reported in this monograph was funded as project number 00/20/01.The views expressed in this publication are those of the authors and not necessarily those of the HTA Programme, NICE or the Department of Health. The editors wish to emphasise that funding and publication of this research by the NHS should not be taken as implicit support for any recommendations made by the authors. Criteria for inclusion in the HTA monograph seriesReports are published in the HTA monograph series if (1) they have resulted from work commissioned for the HTA Programme, and (2) they are of a sufficiently high scientific quality as assessed by the referees and editors.Reviews in Health Technology Assessment are termed 'syst...

show abstract

“…4 Dopamine D1 & D2 Receptors Regulate Muscle Tone 515 been provided by studies using experimental animals Ogren et al 1994;Alcock and Crocker 1999;Hemsley and Crocker 1999a) and other imaging techniques in humans (Scherer et al 1994). Further, it has been reported that clozapine, which does not produce motor side effects in humans or animals (Claghorn et al 1987;Casey 1989), occupies sub-threshold levels of D2 receptors in the striatum (Farde et al 1992;Hemsley and Crocker 1999a) and substantia nigra (Hemsley and Crocker 1999a). The role of dopamine D1 receptors in the production of motor side effects is unclear, and no relationship to D1 receptor occupancy was shown in PET studies (Farde et al 1992).…”

Section: Muscle Rigidity Associated With Antipsychotic Drug Treatmentmentioning

confidence: 99%

Changes in Muscle Tone Are Regulated by D1 and D2 Dopamine Receptors in the Ventral Striatum and D1 Receptors in the Substantia Nigra

Hemsley

Crocker

2001

Neuropsychopharmacology

View full text Add to dashboard Cite

Muscle rigidity associated with antipsychotic drug treatment is believed to result from reduced striatal dopamine neurotransmission. In the current study the regulatory roles of dopamine D1 and D2 receptor subfamilies in the dorsal (DSTR) and ventral striatum (VSTR) and substantia nigra (SN) were investigated on muscle tone, assessed as increases in tonic electromyographic (EMG) activity. Rats were injected with the irreversible The use of antipsychotic drugs to treat the symptoms of schizophrenia can be associated with extrapyramidal side effects, which resemble the symptoms of Parkinson's disease and include increased muscle rigidity in up to 40% of patients (Baldessarini and Tarsy 1980). Further, it has been estimated that up to 30% of patients stop taking their medication because of these motor side effects (Hoge et al. 1990). It is not fully understood why antipsychotic drugs, all antagonists at the dopamine D2 receptor (Creese et al. 1976;Seeman et al. 1976; Peroutka and Snyder 1980) produce motor side effects, although there is some early experimental evidence supporting the view that antagonism of D2 receptors in the striatum is important (Chiodo and Bunney 1983;Creese 1983). Findings from studies in humans using positron emission tomography (PET) have led to the concept that a "threshold" of D2 antagonism by antipsychotic drugs of approximately 70%, exists in the striatum, above which patients experience motor side effects (Farde et al. 1992;Nordstrom et al. 1995). Additional support for the striatal D2 threshold hypothesis has N EUROPSYCHOPHARMACOLOGY 2001 -VOL . 25 , NO . 4 Dopamine D1 & D2 Receptors Regulate Muscle Tone 515 been provided by studies using experimental animals Ogren et al. 1994;Alcock and Crocker 1999;Hemsley and Crocker 1999a) and other imaging techniques in humans (Scherer et al. 1994). Further, it has been reported that clozapine, which does not produce motor side effects in humans or animals (Claghorn et al. 1987;Casey 1989), occupies sub-threshold levels of D2 receptors in the striatum (Farde et al. 1992;Hemsley and Crocker 1999a) and substantia nigra (Hemsley and Crocker 1999a). The role of dopamine D1 receptors in the production of motor side effects is unclear, and no relationship to D1 receptor occupancy was shown in PET studies (Farde et al. 1992). However, there is evidence that antagonism of D1 receptors may result in motor side effects Sedvall et al. 1995) and elicit such motor behaviors as catalepsy in rats (Ogren and Fuxe 1988). As many commonly used antipsychotic drugs, such as chlorpromazine, fluphenazine, and clozapine, are also potent dopamine D1 antagonists (Hacksell et al. 1995), it would be useful to understand the contribution that antagonism of the D1 receptor subfamily makes to the production of muscle rigidity.Experimental research investigating the mechanisms underlying the motor side effects associated with the use of antipsychotic drugs has been handicapped by the lack of a relevant, objective, and quantifiable endpoint of extrapyramidal side effects ...

show abstract

The Risks and Benefits of Clozapine versus Chlorpromazine

Cited by 277 publications

References 0 publications

Time to clozapine response in a standardized trial

Time to clozapine response in a standardized trial

A systematic review of atypical antipsychotic drugs in schizophrenia

Changes in Muscle Tone Are Regulated by D1 and D2 Dopamine Receptors in the Ventral Striatum and D1 Receptors in the Substantia Nigra

Contact Info

Product

Resources

About