Claghorn J, Honigfeld G, Abuzzahab F S, Wang R, Steinbook R, Tuason V, Klerman G
University of Texas Health Science Center, Houston.
J Clin Psychopharmacol. 1987 Dec;7(6):377-84.
Clozapine is an atypical antipsychotic drug with reduced risk of unwanted neurological effects in comparison with other drugs. In this multicenter study, 151 hospitalized schizophrenic patients were randomly assigned to treatment under double-blind conditions to assess the antipsychotic efficacy and safety of clozapine versus chlorpromazine. All patients exhibited tardive dyskinesia or other extrapyramidal side effects associated with at least two prior neuroleptics. Eleven patients were dropped from treatment due to extrapyramidal symptoms while being treated with chlorpromazine; only one clozapine patient's treatment was terminated for this reason. Clozapine patients exhibited clinical improvement superior to that of chlorpromazine patients as assessed by the Brief Psychiatric Rating and Clinical Global Impression scales. These results suggest that clozapine is well tolerated and may be therapeutically superior to chlorpromazine in treating psychotic behavior. Agranulocytosis potential can be minimized by frequent white blood cell counts and removing nonresponding patients from treatment prior to the peak risk period (months 2 through 6).
氯氮平是一种非典型抗精神病药物，与其他药物相比，其产生不良神经效应的风险较低。在这项多中心研究中，151名住院精神分裂症患者被随机分配到双盲条件下接受治疗，以评估氯氮平与氯丙嗪的抗精神病疗效和安全性。所有患者均表现出迟发性运动障碍或与至少两种先前使用的抗精神病药物相关的其他锥体外系副作用。11名患者在接受氯丙嗪治疗时因锥体外系症状退出治疗；只有1名氯氮平患者因此原因终止治疗。根据简明精神病评定量表和临床总体印象量表评估，氯氮平患者的临床改善情况优于氯丙嗪患者。这些结果表明，氯氮平耐受性良好，在治疗精神病行为方面可能在治疗上优于氯丙嗪。通过频繁进行白细胞计数以及在风险高峰期（第2至6个月）之前将无反应患者退出治疗，可以将粒细胞缺乏症的可能性降至最低。
