Abstract

There are compelling data that clozapine has superior efficacy for severely chronic and refractory schizophrenic inpatients. However, the efficacy of clozapine in treatment-resistant outpatients has not been established. Because of the anticipates growing use of clozapine among outpatients, we propose to examine the efficacy and prediction of response of clozapine in treatment-resistant schizophrenic outpatients. After resistance to conventional neuroleptic treatment has been confirmed, outpatients with chronic residual symptoms will participate in a 10-week, double-blind parallel groups to study to determine the effects of clozapine on levels of positive and negative symptoms and functioning. Following the efficacy study, clozapine responders will be followed for one year to accumulate data regarding the longterm effects of clozapine on quality of life and course of illness. Brain morphologic characteristics, determined by magnetic resonance imaging, will be utilized to predict clozapine response. Clozapine-related changes in positive and negative symptoms will be related to volumetric measurements of the amygdala/hippocampus and the prefrontal cortex, respectively. These data may provide new information about clozapine's mechanism of action and the pathophysiology of schizophrenia.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH045074-03
Application #
3384645
Study Section
Treatment Development and Assessment Research Review Committee (TDA)
Project Start
1990-04-01
Project End
1995-03-31
Budget Start
1992-04-01
Budget End
1993-03-31
Support Year
3
Fiscal Year
1992
Total Cost
Indirect Cost

  Institution

Name
University of Maryland Baltimore
Department
Type
Schools of Medicine
DUNS #
003255213
City
Baltimore
State
MD
Country
United States
Zip Code
21201

  Publications

Kawwass, Jennifer F; Sanders, Kristen M; Loucks, Tammy L et al. (2017) Increased cerebrospinal fluid levels of GABA, testosterone and estradiol in women with polycystic ovary syndrome. Hum Reprod 32:1450-1456
Weiner, Elaine; Conley, Robert R; Ball, M Patricia et al. (2010) Adjunctive risperidone for partially responsive people with schizophrenia treated with clozapine. Neuropsychopharmacology 35:2274-83
Kelly, D L; Weiner, E; Ball, M P et al. (2009) Remission in schizophrenia: the relationship to baseline symptoms and changes in symptom domains during a one-year study. J Psychopharmacol 23:436-41
Wonodi, Ikwunga; Reeves, Gloria; Carmichael, Dana et al. (2007) Tardive dyskinesia in children treated with atypical antipsychotic medications. Mov Disord 22:1777-82
Wonodi, Ikwunga; Hong, L Elliot; Thaker, Gunvant K (2005) Psychopathological and cognitive correlates of tardive dyskinesia in patients treated with neuroleptics. Adv Neurol 96:336-49
Buchanan, Robert W; Ball, M Patricia; Weiner, Elaine et al. (2005) Olanzapine treatment of residual positive and negative symptoms. Am J Psychiatry 162:124-9
Wilk, Christopher M; Gold, James M; Humber, Kathy et al. (2004) Brief cognitive assessment in schizophrenia: normative data for the Repeatable Battery for the Assessment of Neuropsychological Status. Schizophr Res 70:175-86
Baymiller, Scott P; Ball, Patricia; McMahon, Robert P et al. (2003) Serum glucose and lipid changes during the course of clozapine treatment: the effect of concurrent beta-adrenergic antagonist treatment. Schizophr Res 59:49-57
Buchanan, Robert W; Summerfelt, Ann; Tek, Cenk et al. (2003) An open-labeled trial of adjunctive donepezil for cognitive impairments in patients with schizophrenia. Schizophr Res 59:29-33
Arango, Celso; Breier, Alan; McMahon, Robert et al. (2003) The relationship of clozapine and haloperidol treatment response to prefrontal, hippocampal, and caudate brain volumes. Am J Psychiatry 160:1421-7

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