Department of Psychiatry, University of Helsinki, Helsinki, Finland.
Int J Psychiatry Clin Pract. 1997;1(4):261-8. doi: 10.3109/13651509709024737.
Eleven consecutive schizophrenic patients with a mean duration of illness of 2.2 (range 0.9-3.8) years and early signs of resistance to conventional neuroleptics were studied prospectively in a 26-week open trial with clozapine (mean dose 192.5 mg at week 8 and 225.0 mg at end-point). Of the ten patients who completed the study, nine improved by 20% or more on total Brief Psychiatric Rating Scale (BPRS) scores; six (good responders) showed more than 30%, and four (fair responders) 21-26% improvement on total Positive and Negative Syndrome Scale (PANSS) scores. The improvement was observed mainly within the first 8 weeks. Duration of illness correlated negatively (P=0.047) with the decrease of positive PANSS scores. The duration of illness of the fair responders was more than twice that of the good responders. Clozapine appears to be a safe and effective treatment alternative for early treatment-resistant schizophrenic patients. These patients seem to respond to relatively low clozapine doses. Early rather than late transfer to clozapine in this population may be of benefit for later clinical outcome.
11 例连续的精神分裂症患者，平均病程为 2.2 年（范围 0.9-3.8 年），且早期出现对传统神经阻滞剂的耐药迹象，前瞻性地在为期 26 周的氯氮平开放试验中进行了研究（第 8 周时的平均剂量为 192.5mg，终点时为 225.0mg）。在完成研究的 10 名患者中，有 9 名患者的总简明精神病评定量表（BPRS）评分提高了 20%或更多；6 名（良好反应者）的阳性和阴性症状量表（PANSS）总分改善超过 30%，4 名（中等反应者）改善 21-26%。这种改善主要发生在第 8 周内。病程与阳性 PANSS 评分的下降呈负相关（P=0.047）。中等反应者的病程是良好反应者的两倍多。氯氮平似乎是一种安全有效的早期治疗耐药性精神分裂症患者的替代治疗方法。这些患者似乎对相对较低剂量的氯氮平有反应。对于这部分人群，早期而不是晚期转用氯氮平可能对以后的临床结果有益。
