Buchanan R W
Maryland Psychiatric Research Center, Baltimore 21228, USA.
Schizophr Bull. 1995;21(4):579-91. doi: 10.1093/schbul/21.4.579.
Clozapine (Clozaril) represents the first major advance in the pharmacological treatment of schizophrenia since the introduction of antipsychotics into clinical practice in the 1950s. Studies consistently support its efficacy for reducing positive symptoms in acutely psychotic patients and in treatment-resistant patients, for preventing positive symptom exacerbations as a maintenance treatment, and for reducing symptoms of hostility and violence. There is evidence to suggest that clozapine may improve social and occupational functioning and quality of life and may reduce affective symptoms, hospitalizations, secondary negative symptoms, and tardive dyskinesia. Its most significant side effects include agranulocytosis, seizures, weight gain, hypotension and tachycardia, sedation, and perhaps rebound psychosis (with abrupt discontinuation of medication).
氯氮平（Clozaril）是自20世纪50年代抗精神病药物引入临床实践以来，精神分裂症药物治疗方面的首个重大进展。多项研究一致支持其在急性精神病患者和难治性患者中减轻阳性症状的疗效，作为维持治疗预防阳性症状加重的疗效，以及减轻敌意和暴力症状的疗效。有证据表明，氯氮平可能改善社会和职业功能以及生活质量，并可能减轻情感症状、住院次数、继发性阴性症状和迟发性运动障碍。其最显著的副作用包括粒细胞缺乏症、癫痫发作、体重增加、低血压和心动过速、镇静作用，以及（突然停药时）可能出现的撤药后精神病复发。
