PMID: 1353492Jul 1, 1992

Should chronic treatment-refractory akathisia be an indication for the use of clozapine in schizophrenic patients?

The Journal of Clinical Psychiatry
H LevinR Ganguli


Clozapine, an atypical neuroleptic, is an effective medication in a subgroup of schizophrenic patients who have either failed to respond to the typical neuroleptics or experienced intolerable side effects such as neuroleptic malignant syndrome and disabling tardive dyskinesia. Its efficacy for persistent and disabling akathisia is less clear. Akathisia, especially the chronic and disabling form, can be a treatment dilemma for the clinician and the patient. We describe three representative case illustrations of schizophrenic patients who had severe, persistent treatment-resistant akathisia. Two of them had refractory psychoses and the third had multiple disabling side effects during treatment with typical neuroleptics. Two had tardive dyskinesia. These patients were treated with clozapine while other neuroleptics were discontinued. During a 2-year follow-up, these patients made impressive social and vocational strides coinciding with a fairly rapid remission of akathisia (under 3 months) and a lesser though notable improvement in the psychoses. Tardive dyskinesia also remitted, though over a period of 6 to 12 months. Our experience leads us to suggest a trial of clozapine in a subgroup of schizophrenic patients, who in addition ...Continue Reading

Related Concepts

Dyskinesia, Medication-Induced
Schizophrenic Psychology
Individual Adjustment
Antipsychotic Effect

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