Remington G J, Addington D, Collins E J, Jones B D, Lalonde P, MacCrimmon D J, MacEwan G W
Department of Psychiatry, University of Toronto, Ontario.
Can J Psychiatry. 1996 Apr;41(3):161-6. doi: 10.1177/070674379604100306.
This study evaluates clozapine and its present role in the pharmacotherapy of schizophrenia.
Clozapine's current clinical status is reviewed, as is its position with respect to other treatment options.
Clozapine represents the prototype of "atypical" neuroleptics, with evidence of clinical efficacy in both positive and negative symptoms, as well as a diminished risk of extrapyramidal side effects. It is the only neuroleptic to date that has established itself as having little, if any, risk of tardive dyskinesia. More recent research has focused on its potential for overall savings in health care costs, as well as possible benefits in the area of neuropsychological functioning.
Evidence suggesting that the course of schizophrenia can be altered by effective treatment favours a systematic approach that optimizes treatment options. While clozapine does not represent a 1st-line agent because of its risk of agranulocytosis, it has an integral role to play in treatment-resistant schizophrenia or in individuals experiencing intolerable side effects with conventional neuroleptics.
本研究评估氯氮平及其在精神分裂症药物治疗中的当前作用。
回顾氯氮平的当前临床状况及其相对于其他治疗选择的地位。
氯氮平是“非典型”抗精神病药物的原型，对阳性和阴性症状均有临床疗效证据，且锥体外系副作用风险降低。它是迄今为止唯一已确定几乎没有迟发性运动障碍风险（若有风险也极小）的抗精神病药物。最近的研究集中在其在总体节省医疗保健成本方面的潜力，以及在神经心理功能领域可能带来的益处。
有证据表明有效治疗可改变精神分裂症病程，这支持采用优化治疗选择的系统方法。虽然氯氮平因有粒细胞缺乏症风险而不代表一线药物，但它在难治性精神分裂症或使用传统抗精神病药物出现无法耐受副作用的个体治疗中具有不可或缺的作用。
