Abstract
Clozapine was synthesised in 1958, and first clinical trials were carried out in the 1960s. These trials already showed that the typical motor side-effects did not occur under clozapine treatment. Although the antipsychotic effect was recognised early, the manufacturer was reluctant to propose the introduction of clozapine as an antipsychotic agent, as it did not meet the “psychopharmacologic dogma” that antipsychotic effect could not be expected without extrapyramidal motor effect [1]. In 1972, clozapine was introduced in Austria, Switzerland, and Germany, within the following 5 years in 30 other countries. More than 100000 schizophrenic patients had been treated with clozapine, antipsychotic effect and tolerance were shown in 13 double-blind controlled studies [2among others]. The rapid increase in the distribution of clozapine dramatically stopped in 1974, when 16 patients developed agranulocytosis under clozapine treatment and eight of them died [3]. In many countries clozapine was withdrawn from the market, while in the German speaking countries, due to the intervention of several renowned psychiatrists, it was not withdrawn and since then is prescribed under precautionary restrictions. Pharmacological and clinical research on clozapine increased after Kane et al. [4] were able to prove the special effect of clozapine on treatment-resistant schizophrenics. That study led to the (re-)introduction of clozapine in most countries.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Stille G, Hippius H (1971) Kritische Stellungnahme zum Begriff der Neuroleptika (anhand von pharmakologischen und klinischen Befunden mit Clozapin).Pharmakopsychiat4: 182–191
Angst J, Bente D, Berner P, Heimann H, Heimchen H, Hippius H (1971) Das klinische Wirkungsbild von Clozapin (Untersuchung mit dem Amp-System).Pharmakopsychiat4: 201–211
Amster H, Teerenhovi L, Barth E, Harjula K, Voupio P (1977) Agranulocytosis in patients treated with clozapine. A study of the Finnish epidemic.Acta Psychiatr Scand56: 241–248
Kane J, Honigfeld G, Singer J, Meltzer H, Clozapine Study Group (1988) Clozapine for the treatment-resistant schizophrenic. A double-blind comparison with chlorpromazine.Arch Gen Psychiatry45: 789–796
Stille G, Fischer-Cornelssen K (1988) Die Entwicklung von Clozapin (Leponex) — ein Mysterium? In: OK Linde (ed.)Pharmako-Psychiatrie im Wandel der Zeit: Erlebnisse und Ergebnisse.Tilia-Verlag, Klingenmünster, 339–348
Hippius H (1989) The history of clozapine.Psychopharmacol99: 53–55
Ereshefsky L, Watanabe MD, Tran-Johnson TK (1989) Clozapine an atypical antipsychotic agent.Clin Pharmacol8: 691–709
Fitton A, Heel R (1990) Clozapine: a review of its pharmacological properties and therapeutic use in schizophrenia.Drugs40: 722–747
Baldessarini R, Frankenburg F (1991) Clozapine: a novel antipsychotic agent.N Engl J Med324: 746–754
Safferman A, Lieberman J, Kane J, Szymansky S, Kinon B (1991) Update on the clinical efficacy and side-effects of clozapine.Schizophr Bull 17:247–261
Klimke A, Klieser E (1995) Das atypische Neuroleptikum (Leponex R) — aktueller Kenntnisstand and neuere klinische Aspekte.Fortschr Neurol Psychiat63: 173–193
Wagstaff AJ, Bryson HM (1995) Clozapine — a review of its pharmacological properties and therapeutic use in patients with schizophrenia who are unresponsive to or intolerant of classical antipsychotic agents.CNSDrugs4: 370–400
Buchanan R (1995) Clozapine: efficacy and safety.Schizophr Bull21: 579–591
Young CR, Longhurst JG, Bowers MB, Mazure CM (1997) The expanding indications for clozapine.Experim Clin Psychopharmacol5: 216–234
Wolters ECH, Hurwitz TA, Mak E (1990) Clozapine in the treatment of Parkinsonian patients with dopaminomimetic psychosis.Neurology40: 832–834
Bonucelli U, Ceravolo R, Maremmani C, Nuti A, Rossi G, Muratorio A (1994) Clozapine in Huntington’s chorea.Neurology44: 821–823
Pakkenberg H, Pakkenberg B (1986) Clozapine in the treatment of tremor.Acta Neurol Scand73: 295–297
Naber D, Holzbach R, Perro C, Hippius H (1992) Clinical management of clozapine patients in relation to efficacy and side-effects.BrJPsychiatry160 (17): 54–59
Peacock K, Gerlach J (1994) Clozapine treatment in Denmark: concomitant psychotropic medication and hematologic monitoring in a system with liberal usage practices.J Clin Psychiatry55: 44–49
Povlsen UJ, Nording U, Fog R, Gerlach J (1985) Tolerability and therapeutic effect of clozapine.Acta Psychiatr Scand71: 176–185
Hirsch S, Puri B (1993) Clozapine: progress in treating refractory schizophrenia.Br Med J 306:1427–1428
Clozapine Study Group (1993) The safety and efficacy of clozapine in severe treatment-resistant schizophrenic patients in the UK.Br JPsychiatry163: 150–154
Pickar D, Owen R, Litman R, Konicki P, Gutierrez R, Rapaport M (1992) Clinical and biological response to clozapine in patients with schizophrenia crossover comparison with fluphenazine.Arch Gen Psychiatry49: 345–353
Breier A, Buchanan R, Kirkpatrick B, Davis O, Irish D, Summerfeldt A, Carpenter W (1994) Effects of clozapine on positive and negative symptoms in outpatients with schizophrenia.Am JPsychiatry151: 20–26
Lieberman J, Safferman A, Pollack S, Szymanski S, Johns C, Howard A, Kronig M, Bookstein P, Kane J (1994) Clinical effects of clozapine in chronic schizophrenia response to treatment and predictors of outcome.Am JPsychiatry151: 1744–1752
Klimke A, Klieser E, Lemmer W (1995) Clozapin in der Rezidivprophylaxe. In: D Naber, F Müller-Spahn (eds)Clozapin. Pharmakologie and Klinik eines atypischen Neuroleptikums.Springer, Berlin Heidelberg London Tokyo, 81–92
Ackenheil M, Braeu H (1976) Antipsychotische Wirksamkeit im Verhältnis zum Plasmaspiegel von Clozapin.Arzneimittelforschung/Drug Res26: 1156–1158
Perry PJ, Miller DD, Arndt SV et al. (1991) Clozapine and norclozapine plasma concentrations and clinical response of treatment-refractory schizophrenic patients.Am JPsychiatry148: 231–235
Kronig M, Mumie R, Szymanski S, Safferman A, Pollack S, Cooper S, Kane J, Lieberman J (1995) Plasma clozapine levels and clinical response for treatment-refractory schizophrenic patients.Am JPsychiatry152: 179–182
Meltzer H, Burnett S, Bastani B, Ramirez L (1990) Effects of six months of clozapine treatment on the quality of life of chronic schizophrenic patients.Hosp Comm Psychiatry41: 892–897
Conley RR, Carpenter WT, Tamminga CA (1997) Time to clozapine response in a standardized trial.Am JPsychiatry154: 1243–1247
Pickar D, Su T-P, Weinberger DR, Coppola R, Malhotra AK, Knable MB, Lee KS, Gorey J, Bartko JJ, Breier A, Hsiao J (1996) Individual variation in D2 dopamine receptor occupancy in clozapine-treated patients.Am J Psychiatry153: 1571–1578
Farde L, Nordström A, Wiesel F-A, Pauli S, Halldin C, Sedvall G (1992) PET analysis of central D1- and D2-dopamine receptor occupancy in patients treated with classical neuroleptics and clozapine: relation to extrapyramidal side-effects.Arch Gen Psychiatry49: 538–544
Nordström A-L, Farde L, Nyberg S, Karlsson P, Halldin C, Sedvall G (1995) D1, D2, and 5-HT2 receptor occupancy in relation to clozapine serum concentration: a PET study of schizophrenic patients.Am JPsychiatry152: 1444–1449
Rosenheck R, Cramer J, Xu W, Thomas J, Henderson W, Frisman L, Fye C, Charney D (1997) A comparison of clozapine and haloperidol in hospitalized patients with refractory schizophrenia.NEngl JMed337: 809–815
Lindström L-H (1988) The effect of long-term treatment with clozapine in schizophrenia: A retrospective study in 96 patients treated with clozapine for up to 13 years.Acta Psychiatr Scand 77:524–529
Gerlach J, Jorgensen EO, Peacock L (1989) Long-term experience with clozapine in Denmark: research and clinical practice.Psychopharmacol99: 92–96
Claghorn J, Honigfeld G, Abuzzahab F, Wang R, Steinbook R, Tuason V, Klerman G (1987) The risks and benefits of clozapine vs. chlorpromazine.J Clin Psychopharmacol7: 377–384
Buchanan RW, Breier A, Kirkpatrick B, Ball P, Carpenter WT (1998) Positive and negative symptom response to clozapine in schizophrenic patients with and without the deficit syndrome.Am J Psychiatry155: 751–760
Mallya A, Roos P, Roebuck-Colgan K (1992) Restraint, seclusion and clozapine.J Clin Psychiatry53: 395–397
Klieser E, Lehmann E, Kinzler E, Wurthmann C, Heinrich K (1995) Randomized, double-blind, controlled trial of risperidone vs. clozapine in patients with chronic schizophrenia.J Clin Psychopharmacol15 (suppl 1): 45–51
Bondolfi G, Dufour H, Patris M, May JP, Billeter U, Eap CB, Baumann P (1998) Risperidone vs clozapine in treatment-resistant chronic schizophrenia: a randomized double-blind study.AmJPsychiatry155: 499–504
Buckley P, Buchanan R, Schulz S, Tamminga C (1996) Catching up on schizophrenia. The Fifth International Congress on Schizophrenia Research Warm Springs, Va, April 8–12, 1995.Arch Gen Psychiatry53: 456–462
Pajonk F, Naber D, Hippius H (1997) Alternativen zum Clozapin? Klinische Erfahrungen mit Risperidon. In: D Naber, F Müller-Spahn (eds):Clozapin. Pharmakologie und Klinik eines atypischen Neuroleptikums.Springer, Heidelberg, 89–104
Still D, Dorson P, Crismon M, Pousson C (1996) Effects of Switching Inpatients With Treatment-Resistant Schizophrenia From Clozapine to Risperidone.Psychiat Sery47: 1382–1384
Lacey R, Preskorn S, Jerkovich G (1995) Is risperidone a substitute for clozapine patients who do not respond to neuroleptics? [Letter].Am JPsychiatry152: 1401
Cavallaro C, Cordoba C, Smeraldi E (1995) A pilot, open study on the treatment of refractory schizophrenia with risperidone and clozapine.Human Psychopharmacol10: 231–234
Daniel DG, Goldberg TE, Weinberger DR, Kleinman JE, Pickar D, Lubick LJ, Williams TS (1996) Different side-effect profiles of risperidone and clozapine in 20 outpatients with schizophrenia or schizoaffectiv disorder: a pilot study.Am JPsychiatry153: 417–419
Lindenmayer J, Alexander A, Park M, Smith R, Apergi F-S, Czobor P (1997) Psychpathological and neuropsychological profile of clozapine vs. risperidone in refractory schizophrenics.Schizophr Res24: 195
Flynn S, MacEwan G, Altman S, Kopola LC, Fredrikson DH, Smith GN, Honer WG (1998) An Open Comparison of Clozapine and Risperidone in Treatment-Resistant Schizophrenia.Pharmacopsychiat31: 25–29
Meyer-Lindenberg A, Gruppe H, Bauer U, Lis S, Krieger S, Gallhofer B (1997) Improvement of cognitive function in schizophrenic patients receiving clozapine or zotepine: results from a double-blind study.Pharmacopsychiat30: 35–42
Tran P, Shamir E, Poyorovski M, Lokshin P, Weizer N, Dorfman P, Mark M, Bikett M, Ben-Assayag E, Shoshani D, Wimmer P, Dossenbach M (1997) Olanzapine in the treatment of patients who failed to respond to or tolerate clozapine.Psychopharmacol Bull33: 599
Treves IA, Neufeld MY (1996) EEG abnormalities in clozapine treated schizophrenic patients.Eur Neuropsychopharmacol6: 93–94
Cohen BM, Keck PE, Satlin A, Cole JO (1991) Prevalence and severity of akathisia in patients on clozapine.Biol Psychiatry163: 1215–1219
Safferman A, Lieberman J, Pollack S, Kane J (1993) Akathisia and clozapine treatment.J Clin Psychopharmacol13: 286–287
Sachdev, P, Kruk J, Kneebone M, Kissane D (1995) Clozapine-induced neuroleptic malignant syndrome: review and report of new cases.J Clin Psychopharmacol15: 365–371
Naber D (1995) A self-rating to measure subjective effects of neurolpetic drugs, relationships to objective psychopathology, quality of life and other clinical variables.Int Clin Psychopharmacol10 (suppl 3): 133–138
Lieberman JA, Saltz BL, Johns CA, Pollak S, Borenstein M, Kane J (1991) The effects of clozapine on tardive dyskinesia.Br JPsychiatry 158:503–510
Naber D, Leppig M, Grohmann R, Hippius H (1989) Efficacy and adverse effects of clozapine in the treatment of schizophrenia and tardive dyskinesia — a retrospective study of 387 patients.Psychopharmacol99: 73–76
Tamminga C, Thaker G, Moran M, Kakigi T, Gao X (1994) Clozapine in tardive dyskinesia: Observations from human and animal model studies.J Clin Psychiatry55 (suppl B): 102–106
Gaebel W, Klimke A, Klieser E (1994) Kombination von Clozapin mit anderen Psychopharmaka. In: D Naber, F Müller-Spahn (eds):Clozapin. Pharmakologie and Klinik eines atypischen Neuroleptikums.Springer, Berlin Heidelberg London Tokyo, 43–58
Sassim N, Grohmann R (1988) Adverse drug reactions with clozapine and simultaneous application of benzodiazepines.Pharmacopsychiat21: 306–307
Centorrino F, Baldessarini R, Kando J, Frankenburg F, Volpicelli S, Puopolo P, Flood J (1994) Serum concentrations of clozapine and its major metabolites: effects of cotreatment with fluoxetine or valproate.Am JPsychiatry 151:123–125
Hiemke C, Weigmann H, Härtter S, Dahmen N, Wetzel H, Müller H (1994) Elevated levels of clozapine in serum after addition of fluvoxamine.J Clin Psychopharmacol14: 279–281
Buchanan RW, Kirkpatrick B, Bryant N, Ball P, Breier A (1996) Fluoxetine augmentation of clozapine treatment in patients with schizophrenia.Am JPsychiatry153: 1625–1627
Shiovitz TM, Welke TL, Tigel PD, Anand R, Hartman RD, Stramek JJ, Kurtz NM, Cutler NR (1998) Cholinergic rebound and rapid onset psychosis following abrupt clozapine withdrawal.Schizophr Bull22: 591–595
Alvir J, Lieberman J, Safferman Z, Schwimmer J, Schaaf JA (1993) Clozapine-induced agranulocytosis. Incidence and risk factors in the United States.N Engl J Med329: 161–167
Young CR, Bowers MB, Mazure CM (1998) Management of the adverse effects of clozapine.Schizophr Bull24: 381–390
Meltzer H, Okayli G (1995) Reduction of suicidality during clozapine treatment of neuroleptic resistant schizophrenia: Impact on risk-benefit assessment.Am J Psychiatry152: 183–190
Reid WH, Mason M, Hogan T (1998) Suicide prevention effects associated with clozapine therapy in schizophrenia and schizoaffective disorder.Psychiatr Sery49: 1029–1033
Classen W, Laux G (1988) Sensorimotor and cognitive performance of schizophrenic inpatients treated with haloperidol, flupenthixol, or clozapine.Pharmacopsychiat21: 295–297
Hagger C, Buckley P, Kenny J, Friedman L, Ubogy D, Meltzer H (1993) Inprovement in cognitive functions and psychiatric symptoms in treatment-refractory schizophrenic patients receiving clozapine.Biol Psychiatr34: 702–712
Goldberg T, Greenberg R, Griffin S, Gold J, Kleinman J, Pickar D, Schulz S, Weinberger D (1993) The effects of clozapine on cognition and psychiatric symptoms in patients with schizophrenia.Br JPsychiatry162: 43–48
Buchanan R, Holstein C, Breier A (1994) The comparative efficacy and long-term effect of clozapine treatment on neuropsychological test performance.Biol Psychiatry36: 717–725
Van Tol H, Bunzow J, Guan H, Ohara K, Bunzow JR, Civelli O, Kennedy J, Seeman P, Niznik HB, Jovanovic V (1991). Cloning of the gene for a human dopamine D4 receptor with high affinity for the antipsychotic clozapine.Nature350: 610–614
Rao PA, Pickar D, Gejman PV, Ram A, Gershon ES, Gelernter J (1994) Allelic variation in the D4 dopamine receptor (DRD4) gene does not predict response to clozapine.Arch Gen Psychiatry51: 912–917
Rietschel M, Naber D, Oberländer H, Holzbach R, Fimmers R, Eggermann K, Möller HJ, Propping P, Nöthen MM (1996) Efficacy and side-effects of clozapine testing for association with allelic variation in the dopamine D4 receptor gene.Neuropsychopharm15: 491–496
Nöthen MM, Rietschel M, Erdmann J, Oberländer H, Möller HJ, Naber D, Propping P (1995) Genetic variation of the 5-HT2A-receptor and response to clozapine.Lancet346: 908–909
Morris S, Hogan T, McGuire A (1998) The cost-effectiveness of clozapine.Clin Drug Invest15: 137–152
Meltzer H, Cola P, Way L, Thompson P, Bastani B, Davies M, Snitz B (1993) Cost effectiveness of clozapine in neuroleptic-resistant schizophrenia.Am JPsychiatry150: 1630–1638
Reid W, Mason M, Toprac M (1994) Savings in hospital bed-days related to treatment with clozapine.Hosp Commun Psychiatry45: 261–264
Davies LM, Drummond MF (1993) Assessment of costs and benefits of drug therapy for treatment-resistant schizophrenia in the United Kingdom.Br J Psychiatry162: 38–42
Jonsson D, Walinder J (1995) Cost-effectiveness of clozapine treatment in therapy-refractory schizophrenia.Acta Psychiatr Scand92: 199–201
Grohmann R, Schmidt LG, Spiess-Kiefer C, Rüther E (1989) Agranulocytosis and significant leucopenia with neuroleptic drugs: results from the AMÜP program.Psychopharmacol99: 109–112
Rosenheck R, Cramer J, Xu W, Thomas J, Henderson W, Frisman L, Fye C, Charney D (1997) A comparison of clozapine and haloperidol in hospitalized patients with refractory schizophrenia.New Engl JMed337: 809–815
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2000 Springer Basel AG
About this chapter
Cite this chapter
Naber, D., Haasen, C., Perro, C. (2000). Clozapine: the first atypical antipsychotic. In: Ellenbroek, B.A., Cools, A.R. (eds) Atypical Antipsychotics. Milestones in Drug Therapy MDT. Birkhäuser, Basel. https://doi.org/10.1007/978-3-0348-8448-8_8
Download citation
DOI: https://doi.org/10.1007/978-3-0348-8448-8_8
Publisher Name: Birkhäuser, Basel
Print ISBN: 978-3-0348-9571-2
Online ISBN: 978-3-0348-8448-8
eBook Packages: Springer Book Archive