Is Clozapine an Effective Treatment for Schizophrenia?

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Is Clozapine an effective treatment for schizophrenia?
What is schizophrenia and what are the symptoms –
Figure 1
Schizophrenia is a brain disorder which can affect a person’s mental well-being. Suffering from schizophrenia can terrify people and make them withdrawn from family and friends or make them extremely agitated. Some people with the disorder are known to hear voices, believe people are trying to harm them or are reading their minds. The exact cause is unknown, however many scientists believe that genes and environment both play a role together. Within the brain, the level of dopamine and glutamine, both chemical messengers, may be out of balance. Another cause may come from the brain structure being slightly abnormal. For example this brain scan (see figure 1) of identical twins show that the brain on the left has much larger/fluid filled ventricles which is common for schizophrenic patients, compared with the twin that does not have the illness on the right. [1]

It is difficult to acquire accurate statistics on schizophrenia due to the nature of the illness, however it is estimated that about 7 per thousand of the adult population, mostly in the age group 15-35 years are effected by the illness. This has been calculated to be 24 million people worldwide. Though the occurrence is quite low compared to other illnesses, it lasts a long period of time can sometimes cause a long-term change in the body.

There are three different types of symptoms are a person with schizophrenia can suffer from[2]:

* Positive –
* Hallucinations.
* Delusions.
* Thought disorders.
* Movement disorders.
* "Voices" are the most common type of hallucination in schizophrenia.

* Negative –
* Lack of pleasure in everyday life.
* Lack of ability to begin and sustain planned activities. * Speaking little, even when forced to interact.

* Cognitive –
* Cognitive symptoms are subtle.
* Inability to understand information and use it to make decisions. * Trouble focusing or paying attention.
* Inability to use information immediately after learning it.

Clozapine
Clozapine is an antipsychotic medication used in the treatment of schizophrenia, and can also be used to treat bipolar disorder. It can also be sold under many different names such as Clozaril, Azaleptin, Leponex and in the UK; Denzapine, Zaponex. Clozapine is used as a last resort treatment in patients that have not responded to other anti-psychotic treatments before and also due to its danger of causing agranulocytosis. It is, however, one of the very effective anti-psychotic treatment choices. It was the first of the atypical antipsychotics to be developed and was first introduced in Europe in 1971. However in 1975 it was withdrawn by the manufacturer after it began to show that it caused agranulocytosis, a condition involving a dangerous decrease in the number of white blood cells, that led to death in some patients. In 1989, after studies demonstrated that it was more effective for treating schizophreniathe U.S. Food and Drug Administration (FDA) approved clozapine's use but only for treatment-resistant schizophrenia. The FDA requires blood testing for patients taking clozapine.[Patients are monitored weekly for the first six months. If there are no low counts the patient can be monitored every two weeks for an additional six months. Afterwards, the patient may qualify for every four week monitoring. Clozapine has numerous severe side effects including agranulocytosis, bowel infarction, seizures, myocarditis, and diabetes. Additionally, it also often causes less serious side effects such as sialorrhea and weight gain. It is also used for reducing the risk of suicide in patients judged to belong to a high-risk group with chronic risk for suicidal behavior. Clozapine was shown to prolong the time to suicidal attempt significantly greater...
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