Tolerability of long term clozapine treatment

Abstract
Tolerability of long term clozapine treatment (7–8 years) was investigated in 27 female patients (age 34–77 years). Diagnosis according to ICD 9 was schizophrenia in 21 patients, severe psychomotor agitation with mental deficiency in 4 patients and an “endogenous” depression in 2 patients. All patients had previously been treated with different neuroleptics but with inadequate response or distressing side effects. The duration of the disorder was 10–36 years, duration of hospitalisation 10–36 years. At the day of investigation the total dose of clozapine ranged from 52–826 g, the average total dose being 385 g. The daily dose of clozapine ranged from 75 to 600 mg, the average daily dose being 225 mg. Only 2 patients were treated exclusively with clozapine, the other 25 patients were also receiving other neuroleptics. Seventy eight per cent of the investigated patients complained about hypersalivation and 63% showed overweight. In 37% of the patients the EEG demonstrated abnormalities. Mild parkinsonism was reported in 15% and akathisia in 11% of the patients, all these patients being on combined treatment. Clozapine did not induced tardive dysakinesia (TD) in any of the patients within a treatment period of 7–8 years. It is concluded that a potential benefit of clozapine includes a low incidence of neurological side effects even after long term administration.