Clozapine Versus Chlorpromazine for Treatment-Unresponsive Schizophrenia

Clozapine Response and Biogenic Amines in Schizophrenia

This study will examine the physical response to clozapine or chlorpromazine in people with schizophrenia that has not improved with treatment.

This is a longitudinal double-blind 12-week study of the clinical and biochemical response to clozapine or chlorpromazine in a group of treatment-refractory schizophrenic patients.

The study has 4 phases: (1) A recruitment period; (2) a period of discontinuation of psychotropic medication; (3) a drug-washout period; and (4) a 12-week double-blind trial of clozapine or chlorpromazine.

Inclusion Criteria:

• 19-60 years of age
• Diagnosis of schizophrenia
• BPRS score > 50
• Clinical Global Impressions rating > 4
• One of the following: BPRS items rated greater than or equal to 4, conceptual disorganization, suspiciousness, hallucinations, unusual thought content.
• At least 2 six-week trials of different neuroleptics given at a dosage equivalent to at least 600 mg per day of chlorpromazine OR at least 1 eight-week trial of a neuroleptic given at a dosage equivalent to at least 800 mg per day of chlorpromazine.
• The patient (or the patient's authorized legal representative) must understand the nature of the study and sign the informed consent.

Exclusion Criteria:

• History of substance dependence within the past 2 months
• Major medical problems precluding the use of clozapine
• Pregnancy or lactation
• A serious suicide/homicide risk