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Background : Clozapine is an atypical antipsychotic drug, which differs from typical antipgychotics(e.g., haloperidol) producing minimal extrapyramidal side effects in human. Its therapeutic effectiveness has been found to be superior to standard antipsychotic drugs in double-blind, controlled studi...

Background : Clozapine is an atypical antipsychotic drug, which differs from typical antipgychotics(e.g., haloperidol) producing minimal extrapyramidal side effects in human. Its therapeutic effectiveness has been found to be superior to standard antipsychotic drugs in double-blind, controlled studies. Method : We investigated the clozapine's efficacy and adverse effects in the Korean treatment-resistant schizophrenics, who were assigned, in a prospective, open comparative trial, to clozapine(N=28 ; up to 600mg/day) or haloperidol(N=20 ; 10-25mg/day) for eight weeks. The overall clinical state was assessed every two weeks until the end of the 8th week using the Brief Psychiatric Rating Scale(BPRS) and the Clinical Global Impression(CGI) scale. Systematic assessments of extrapyramidal symptoms were made biweekly using the Simpson-Angus Scale for Extrapyramidal Side Effects. Results : Clozapine produced significantly greater improvement than haloperidol on the BPRS. the CGI and the Simpson-Angus scales. 82% of the clozapine-treated patients were categorized as responders, who showed at least a 20% decrease in total BPRS score, compared with 35% of haloperidol-treated patients. Unlike haloperidol, extrapyramidal reactions occurred in only one patient among those receiving clozapine. Hypersalivation, sedation and hypotension were the most common side effects observed. Conclusion: Our results suggest that clozapine is an effective antipsychotic drug for the Korean treatment-resistant schizophrenics, who are non-responsive to or unable to tolerate classical antipsychotic drugs.

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