Fleischhacker W W, Hummer M, Kurz M, Kurzthaler I, Lieberman J A, Pollack S, Safferman A Z, Kane J M
Department of Biological Psychiatry, Innsbruck University Clinics, Austria.
J Clin Psychiatry. 1994 Sep;55 Suppl B:78-81.
The report (1) provides an overview of clozapine doses used in trials conducted in Europe and the United States, (2) compares data on efficacy, and (3) compares side effects of clozapine from recent European and U.S. investigations. The reviewed European trials used a mean dose of 283.7 mg/day, while the mean dose in the U.S. studies was 444 mg/day. Even though the mean doses used in the United States are considerably higher than those used in Europe, the response rates for the two continents are strikingly similar. The main differences in a comparison of two samples evaluated in New York and Innsbruck were found in the prevalence of seizures (Innsbruck, 0%; United States, 7.1%) and confusion (Innsbruck, 0%; United States, 14%). Excitement was less prevalent in the U.S. study. The data presented appear to suggest that a lower dose of clozapine may be as effective as a higher dose in the management of treatment-resistant schizophrenic patients and may cause fewer side effects.
（1）概述了在欧洲和美国进行的试验中使用的氯氮平剂量；（2）比较了疗效数据；（3）比较了近期欧洲和美国调查中氯氮平的副作用。经审查的欧洲试验使用的平均剂量为283.7毫克/天，而美国研究中的平均剂量为444毫克/天。尽管美国使用的平均剂量远高于欧洲，但两大洲的有效率惊人地相似。在纽约和因斯布鲁克评估的两个样本的比较中，主要差异在于癫痫发作的发生率（因斯布鲁克为0%；美国为7.1%）和意识模糊（因斯布鲁克为0%；美国为14%）。在美国的研究中，兴奋症状的发生率较低。所呈现的数据似乎表明，在治疗难治性精神分裂症患者时，较低剂量的氯氮平可能与较高剂量一样有效，且副作用可能更少。
