Treating Pharmacoresistant Schizophrenia  in Elderly With Clozapine � Safety Profile  Experience from Mental Hospital Kromeriz,  Czech Republic

Luzny Jan

Volume : II, Issue : VIII, August - 2013

Treating Pharmacoresistant Schizophrenia in Elderly With Clozapine � Safety Profile Experience from Mental Hospital Kromeriz, Czech Republic

Luzny Jan

Abstract :

Background: Pharmacoresistant schizophrenia is not a rarity. It is defined as un successfull treatment of schizophrenia by two different sorts of antipsychotics with different mechanism of action, lasting up at least six weeks with dosage which is equivalent to 1000 mg per day of chlorpromazine in the period of last five years. Clozapine is used as a „rescue�antipsychotic when previous treatment of schizophrenia fails. The objective is to evaluate effectiveness, safety and side effects of clozapine used for treatment senior patients with pharmacoresistant schizophrenia hospitalized in inpatient psychogeriatric ward in Mental hospital in Kromeriz (2010-2011). Subjects and methods: psychiatric scales Positive and Negative Symptoms of Schizophrenia (PANSS) and Clinical Global Impression (CGI) were used initially before starting with clozapine treatment, then after 4. and 8. weeks and finally after 12 weeks of using clozapine. White blood cells and agranulocytes count was monitored initially before starting with clozapine treatment, t then after 4. and 8. weeks and finally after 12 weeks of using clozapine. Side effects caused by clozapine were monitored after 12 weeks of using clozapine. Results: clozapine decreased the main symptomatology of pharmacoresistant schizophrenia in old age patients, with no deterioration of white blood cells count. Side effects of clozapine in old age patients were tolerable although sedation, hypotension, agitation, weight gain and deterioration in metabolit parameters were not rare in studied group of senior patients. Conclusion: Clozapine can be used as „rescue� antipsychotic for treating the pharmacoresistant schizophrenia in elderly. However, monitoring of side effects of clozapine used in elderly and watchful awareness is unevitable.