Original Article
Clozapine-Induced Agranulocytosis -- Incidence and Risk Factors in the United States
N Engl J Med 1993; 329:162-167July 15, 1993
- Abstract
Background
Clozapine is an atypical antipsychotic agent that is more effective than standard neuroleptic drugs in the treatment of patients with refractory schizophrenia. Unlike classic neuroleptic agents, clozapine is not associated with the development of acute extrapyramidal symptoms or tardive dyskinesia. The main factor limiting its use is the risk of potentially fatal agranulocytosis, estimated to occur in 1 to 2 percent of treated patients. After clozapine was approved by the Food and Drug Administration, it became available for marketing in the United States in February 1990 only as part of a special surveillance system (the Clozaril Patient Management System, or CPMS), in which a weekly white-cell count was required for the patient to receive a supply of the drug.
Methods
We evaluated the CPMS data for February 1990 through April 1991 by survival analysis to determine the incidence of agranulocytosis and the effects of potential risk factors such as age and sex. Data were available for 11,555 patients who received clozapine during the period after marketing began.
Results
Agranulocytosis developed in 73 patients, resulting in death from infectious complications in 2 patients. Episodes of agranulocytosis occurred in 61 patients within three months after they began treatment. The cumulative incidence of this side effect was 0.80 percent (95 percent confidence interval, 0.61 to 0.99) at 1 year and 0.91 percent (95 percent confidence interval, 0.62 to 1.20) at 1 1/2 years. The risk of agranulocytosis increased with age and was higher among women.
Conclusions
The occurrence of agranulocytosis is a substantial hazard of the administration of clozapine, but this hazard can be reduced by monitoring the white-cell count. The increasing risk of agranulocytosis with age and the reduced incidence after the first six months of treatment provide additional guidelines for the prescription and monitoring of clozapine treatment in the future.
Media in This Article
Figure 1
Cumulative Incidence of Agranulocytosis among 11,555 Patients Taking Clozapine.Figure 2
Hazard Rates for Agranulocytosis, According to Month of Follow-up.Article Activity
- Article
The introduction of the dibenzodiazepine antipsychotic agent clozapine (8-chloro-11[4-methyl-1-piperazinyl]-5H-dibenzo-[b,e][1,4] diazepine) was an important development in the pharmacotherapy of schizophrenia. Preclinical1-5 and clinical6-9 investigations have shown that clozapine has properties different from those of classic neuroleptic agents, as well as a substantial therapeutic advantage. Clozapine was found to be superior to standard antipsychotic drugs in the treatment of refractory schizophrenia7. Unlike classic neuroleptic agents, clozapine did not cause parkinsonism, dystonia,8 or tardive dyskinesia, nor did it elevate prolactin levels9.
Despite the promise of clozapine, its use has been limited by its propensity to cause agranulocytosis. Reports from Europe in the 1970s described rates of agranulocytosis among patients given clozapine (0.05 to 2 percent) that were higher than the rates among patients given standard psychotropic drugs10-16. Moreover, a number of patients died11,13. Clozapine-induced agranulocytosis selectively affects precursors of polymorphonuclear leukocytes in the bone marrow and can be reversed without hematologic sequelae if treatment is stopped promptly17,18. The pathophysiologic mechanism is unknown, but there is evidence that the reaction is immunologically mediated19. Previous estimates of the rate of clozapine-induced agranulocytosis among American patients, based on relatively small numbers who received clozapine on an investigational basis, ranged between 1 and 2 percent17. The generalizability of these estimates is uncertain, since they were based on stringently selected patients treated in research studies at a few tertiary care institutions.
Clozapine was approved by the Food and Drug Administration in October 1989 and was first marketed in the United States in February 1990. It was distributed solely by one firm (Caremark Homecare, an affiliate of Baxter Healthcare, Lincolnshire, Ill.) in conjunction with weekly measurement of the white-cell count under the Clozaril Patient Management System (CPMS) until this arrangement for distribution was discontinued on May 31, 1991. The data collected through the CPMS provided an opportunity to estimate the incidence of clozapine-induced agranulocytosis and to examine potential risk factors for it in the cohort of patients who received clozapine after commercial distribution of the drug began in the United States.
Methods
Data Collection and Patients
Each patient taking clozapine (Clozaril, Sandoz, East Hanover, N.J.) was assigned a case administrator who was responsible for monitoring compliance with measurement of the white-cell count, maintaining regular contact with the treating physician, and maintaining the patient's records. The case administrator recorded the patient's age, sex, height, weight, and diagnosis during registration for treatment. Weekly visits were scheduled for monitoring white-cell counts and dispensing the drug. Only one week's supply of medication was dispensed to facilitate compliance with hematologic monitoring. The data collected during these visits included the amount of drug dispensed and the reasons for interrupting or discontinuing treatment. Pilot testing of the CPMS revealed a compliance rate of more than 99 percent for weekly measurement of the white-cell count20. Blood samples were delivered to a central laboratory for analysis (Roche Biomedical Laboratories, Raritan, N.J.); the coefficients of variation were 5, 3, and 2 percent for white-cell counts with expected values of 2000, 7000, and 18,000 cells per cubic millimeter, respectively. The hematologic test results were provided weekly to the treating physician. The following results were immediately communicated by the case administrator to the treating physician: a white-cell count below 3500 per cubic millimeter; a large absolute drop in the white-cell count, even if the count remained above 3500 per cubic millimeter; or three consecutive drops in the count. Treatment guidelines specified that a complete blood count with a differential count be determined twice weekly if the white-cell count dropped below 3500 per cubic millimeter. Clozapine treatment was interrupted if the white-cell count fell below 3000 per cubic millimeter or the absolute polymorphonuclear-leukocyte count fell below 1500 per cubic millimeter, and daily hematologic monitoring was instituted; treatment could be resumed if the white-cell count and the absolute polymorphonuclear-leukocyte count returned to levels above 3000 and 1500 per cubic millimeter, respectively. The guidelines stipulated that clozapine be permanently discontinued if leukopenia developed, indicated by a white-cell count below 2000 per cubic millimeter or an absolute polymorphonuclear-leukocyte count below 1000 per cubic millimeter. Weekly monitoring was continued for at least four weeks after clozapine was discontinued for any reason21. A master list was maintained (by Caremark) of all patients reported to have agranulocytosis and patients withdrawn from clozapine treatment because of leukopenia.
Treatment data from the distributor and hematologic data from the central laboratory on each visit were merged by the drug manufacturer according to the patient's social security number. If this identifier was unavailable, other identifiers were used, including the patient's name. The data were processed in biweekly batches of records. The proportion of unlinkable records was 8 percent for batches processed at the start of the period after marketing began, declining to 3 to 4 percent within a month and to 1 percent for batches processed at the end of 1990. The unlinked records did not contain any white-cell counts indicating agranulocytosis or leukopenia. The demographic, clinical, and hematologic data, without the patient's name, were further processed and analyzed at the Mental Health Clinical Research Center of Hillside Hospital, Long Island Jewish Medical Center.
Analyses were limited to patients taking clozapine during the period from February 5, 1990, through April 1991 who had been followed for at least three weeks. Patients without agranulocytosis were included in the study cohort only if blood samples were available for at least three time points. Patients who began taking clozapine before marketing but who were still taking it during the period after marketing began were included in the analyses. Patient accrual continued through the study period.
The analyses were performed on data from 11,555 patients, including 1353 who began treatment during the premarketing period; 5323 patients with less than three weeks of follow-up and 164 patients with only two hematologic records from the data base were excluded. Demographic and base-line clinical information was available for 11,382 of the 11,555 patients in the analyses. The numbers of patients followed for one, three, and six months were 11,033, 8608, and 5780, respectively. Follow-up covering 1 1/2 years was available for 898 patients who had begun treatment during the premarketing period. Clozapine treatment was stopped for reasons other than agranulocytosis or leukopenia in 1281 patients, including 1244 whose recorded white-cell count never fell below 3500 per cubic millimeter. The most common reasons for stopping treatment were a lack of response (34 percent), noncompliance (18 percent), and adverse reactions other than agranulocytosis or leukopenia (16 percent).
Patients with Agranulocytosis
Patients with agranulocytosis were identified from the hematologic records and the master list of patients reported to have this complication. An episode of agranulocytosis was indicated by a confirmed absolute polymorphonuclear-leukocyte count below 500 cells per cubic millimeter. Patients whose hematologic records indicated an episode of agranulocytosis were checked against those on the master list. Nine patients not included on the master list had single hematologic records that indicated agranulocytosis. The records of these nine patients were determined to contain errors: the white-cell counts determined in six patients immediately before and after the supposed episodes were clearly incompatible with agranulocytosis; the seventh patient was mistakenly thought to have agranulocytosis because of a clerical error (transposition of the digits of a social security number); and the eighth and ninth patients, in whom agranulocytosis was detected at base line, had never taken clozapine.
Two patients who had agranulocytosis according to the master list had no records in the hematologic data base. The dates of the start of treatment and agranulocytosis in these two patients were added to the data base. Seventeen patients on the master list had no hematologic records indicating this complication. Further investigation revealed that they had been hospitalized and their blood monitoring had been taken over by the hospitals. All but 4 of these 17 patients had recorded white-cell counts below 3500 per cubic millimeter before the date that agranulocytosis occurred. For 10 of these 17 patients, the white-cell counts indicating agranulocytosis and the dates of these counts were recovered from hospital laboratories; for the other 7 patients, the dates of agranulocytosis were estimated on the basis of the dates of hospitalization and ancillary hematologic data. In all, 73 patients were considered to have had agranulocytosis.
Prodrome to Agranulocytosis
The onset of the prodrome to agranulocytosis was determined by examining individual plots of white-cell counts and determining the date from which the count showed a continual decline until agranulocytosis developed, allowing for one possible increase in the count during that interval but only to a level that did not exceed the base-line count. The duration of the prodrome, defined as the time from onset to the date of agranulocytosis, was determined in 68 of the 73 patients. In one patient, an atypical and irregular pattern of white-cell counts precluded identification of the date of onset. In four patients, weekly data for the period immediately before agranulocytosis were sparse or missing.
Limitations of the Data
The CPMS data were not specifically designed to provide information about the incidence of agranulocytosis and the risk factors for this complication. Potentially interesting characteristics of the patients, such as their race or ethnic background, were not routinely recorded on the registration forms. The blood counts of patients who were hospitalized for agranulocytosis were often not included in the data base because their blood monitoring was taken over by the hospitals. However, the data did provide information necessary to estimate the incidence of agranulocytosis as well as the effects of several potential risk factors.
Statistical Analysis
The Lifetest and PHREG procedures of SAS/STAT software22,23 were used to carry out life-table and Cox proportional-hazards regression analyses. The regression analyses tested for the effects of age, sex, and base-line white-cell count on the risk of agranulocytosis. Survival analysis was particularly appropriate because the accrual of patients continued throughout the study period, resulting in unequal duration of follow-up24.
The effects of dosage were tested with the use of conditional logistic regression. Each patient with agranulocytosis was matched according to the date of the initial visit with 10 randomly selected controls (other patients in the data base who did not have agranulocytosis) for whom data were available through the date when agranulocytosis developed in the patient. Four patients had fewer than 10 controls. One patient, who made the initial visit on December 24, was matched with six controls who made their initial visits during the week surrounding this date. The PHREG procedure23 was used to carry out the conditional logistic regression. The analyses evaluated the effects of the maximal dose, defined as the highest dose received during clozapine treatment, the last recorded dose, and the cumulative dose. The collection of data on dosage in the controls was cut off on the date when agranulocytosis developed in the patient. Body weight was controlled for in the dosage analyses.
The association between the duration of the prodrome and age, sex, and the base-line white-cell count was also investigated.
Results
Of the 11,382 patients for whom demographic data were available, 7032 were men (62 percent) and 4350 were women (38 percent). Table 1Table 1
Clinical Variables, Clozapine Dosage, and White-Cell Count in Patients with and without Agranulocytosis. shows their clinical characteristics, maximal doses, and white-cell counts according to whether or not agranulocytosis developed. The recorded diagnosis was schizophrenia in 95 percent of the patients, affective psychosis in 2.2 percent, and organic psychosis in 1.0 percent.Table 2Table 2
Outcomes in 514 Patients with at Least One White-Cell Count below 3500 per Cubic Millimeter. shows the outcomes in 514 patients with at least one white-cell count below 3500 per cubic millimeter. The count recovered to a level above 3500 per cubic millimeter with either continued or resumed treatment in 266 patients; it did not fall below 3000 per cubic millimeter in 200 of these 266 patients. Although the count recovered in 54 patients, they stopped taking clozapine. In 15 patients the final available white-cell count was below 3500 per cubic millimeter. Further investigation revealed that neither agranulocytosis nor leukopenia had developed in any of these patients. One hundred six patients were permanently withdrawn from clozapine treatment because of leukopenia. Seventy-three patients had episodes of agranulocytosis; two of these patients died of sepsis25 (a 45-year-old man and a 76-year-old woman). In 24 patients the white-cell count did not fall below 3500 per cubic millimeter before the occurrence of agranulocytosis, including the 2 patients for whom only the dates of initial treatment and agranulocytosis were available. In 16 of these 24 patients the count remained above 3500 per cubic millimeter within eight days before agranulocytosis occurred.The cumulative incidence of agranulocytosis was 0.80 percent (95 percent confidence interval, 0.61 to 0.99) at 1 year and 0.91 percent (95 percent confidence interval, 0.62 to 1.20) at 1 1/2 years (Figure 1Figure 1
Cumulative Incidence of Agranulocytosis among 11,555 Patients Taking Clozapine.). This complication developed in 23 patients within two months after the start of therapy, in 61 within three months, and in 70 within six months. In only one patient did it occur after one year. The hazard rate for agranulocytosis peaked during the third month of treatment (Figure 2Figure 2Hazard Rates for Agranulocytosis, According to Month of Follow-up.). In the two patients with fatal agranulocytosis, this disorder developed within 1 1/2 months after they began clozapine treatment.Agranulocytosis developed in 42 women and 31 men. As compared with the patients without agranulocytosis, these 73 patients were considerably older and had lower base-line white-cell counts. Univariate survival analyses showed that the risk of agranulocytosis increased with age (risk ratio, 1.06; 95 percent confidence interval, 1.05 to 1.08) and was higher among women (risk ratio, 2.23; 95 percent confidence interval, 1.40 to 3.54) (Table 3Table 3
Risk Ratios for Risk Factors for Agranulocytosis.). Although adjustment for age reduced the effect of sex (risk ratio, 1.60; 95 percent confidence interval, 0.99 to 2.58), adjustment for sex did not alter the effect of age (risk ratio, 1.06; 95 percent confidence interval, 1.04 to 1.07). The base-line white-cell count was inversely related to the risk of agranulocytosis, but the effect of this association was small and not significant after adjustment for age and sex. The effects of age and sex were essentially unchanged after adjustment for the base-line white-cell count.Risk ratios for 10-year age groups were computed, with patients 21 to 30 years old serving as the reference group (Figure 3Figure 3
Risk Ratios for Agranulocytosis, According to Age Group.). The risk ratio for the group less than 21 years old was greater than 1, indicating that the risk was higher in this group than in the reference group. The risk in the group less than 21 years old was also higher than the risk in the group 31 to 40 years old (risk ratio, 1.75; 95 percent confidence interval, 0.53 to 5.86), although the lower confidence limit was less than 1.The dose of clozapine had no effect on the risk of agranulocytosis in the conditional logistic-regression analyses. The odds ratios, adjusted for age, sex, and weight, for the maximal dose (in 100-mg increments), last recorded dose (in 100-mg increments), and cumulative dose (in 10,000-mg increments) were 1.11 (95 percent confidence interval, 0.95 to 1.32), 1.10 (95 percent confidence interval, 0.93 to 1.30), and 1.01 (95 percent confidence interval, 0.87 to 1.17), respectively.
The mean (±SD) duration of the prodrome of agranulocytosis was 29.3 ±12.6 days (median, 28). Thus, in half of the 68 patients for whom this information was available, the white-cell count started to decline at least four weeks before agranulocytosis occurred. In only six patients did the prodrome last two weeks or less. However, 16 patients, all of whom had declining white-cell counts in the period before agranulocytosis, had no white-cell counts below 3500 per cubic millimeter within eight days before the occurrence of agranulocytosis. Although the patients who eventually had agranulocytosis had consistent declines in their white-cell counts, their clozapine treatment was continued until their counts fell below 3000 per cubic millimeter.
Neither age nor sex was associated with the duration of the prodrome. The length of the prodrome correlated with the magnitude of the base-line white-cell count (r = 0.26; 95 percent confidence interval, 0.02 to 0.47) -- i.e., in patients whose count had further to decline, the period before their granulocyte count dropped below 500 per cubic millimeter was longer.
Discussion
The incidence of agranulocytosis was 0.80 percent at 1 year and 0.91 percent at 1 1/2 years. The majority of cases of agranulocytosis (61 of 73 patients) occurred within the three months after the start of treatment, with the risk peaking in the third month. Only three cases occurred after 6 months, and one case after 1 1/2 years. The prodromal period leading to agranulocytosis was long in the majority of cases. However, agranulocytosis developed in 16 patients within eight days of white-cell counts above 3500 per cubic millimeter, the threshold level for beginning semiweekly monitoring, and above the threshold level for interrupting clozapine treatment (3000 per cubic millimeter), despite consistent declines in the counts. These results suggest that the frequency of hematologic monitoring could be reduced after the initial six months of treatment, provided that clozapine treatment may be interrupted at a higher threshold level for the white-cell count in patients whose counts show consistent declines.
The risk of agranulocytosis increased with age, although it was somewhat higher among patients below the age of 21 years than among those 21 to 40 years old. Although the higher risk among women was reduced after adjustment for age, the adjusted risk ratio for women (1.60; 95 percent confidence interval, 0.99 to 2.58) was still substantial. These results are consistent with previous reports associating female sex and increasing age with an increased risk of drug-induced neutropenia and agranulocytosis26,27.
The risk of clozapine-induced agranulocytosis has been reported to be increased among patients of Ashkenazi Jewish descent with the haplotype HLA-B38, DR4,DQw328. Unfortunately, information about the race or ethnic background of the patients in our study was not available in our data base.
Two of the 73 patients who had agranulocytosis according to our data base died25. In addition, five patients who began taking clozapine after April 1991 have since died of disorders related to agranulocytosis (two women 59 and 72 years old and three men 40, 49, and 60 years old) (Krassner M [Sandoz]: personal communication). All five patients died within three months after they began clozapine treatment. In all other patients with agranulocytosis, this complication has proved reversible, with no persisting hematologic sequelae17,29. Given the increased risk of agranulocytosis and the limited data on the efficacy, safety, and optimal dose range of clozapine in elderly patients, clinicians should be particularly careful in selecting and treating elderly patients until the risks and benefits of clozapine in this age group are better known.
Since the discontinuation of the CPMS system, treating physicians have had primary responsibility for hematologic monitoring. Experience suggests that it may not be possible to prevent the occurrence of agranulocytosis, but the purpose of hematologic monitoring is to prevent complications and deaths due to this disorder. Our report suggests that the hematologic guidelines required of clinicians by the maker of clozapine (Sandoz) can be modified so that treatment with this drug can be managed in a less burdensome yet safe manner. Currently, in several European countries, including the United Kingdom, Germany, and Finland, the frequency of monitoring is reduced after the initial 18-week period of maximal risk, to testing every 2 weeks in the United Kingdom and at least monthly in Germany and Finland (Jager P [Sandoz]: personal communication). Future modifications might include reducing the frequency of white-cell counts to testing every two weeks after six months of treatment. However, clinicians must pay attention to patterns of decline in the counts in addition to absolute threshold levels. In addition, new methods of treating agranulocytosis that stimulate granulopoiesis (the use of granulocyte and granulocyte-macrophage colony-stimulating factors30-32) should be evaluated to determine whether they can reduce the complications associated with clozapine-induced agranulocytosis.
Supported by a Research Scientist Development Award (MH-00537) to Dr. Lieberman from the National Institute of Mental Health and the Mental Health Clinical Research Center of Hillside Hospital (MH-41960).
We are indebted to Freddy Howard (Hillside Hospital), Regina Ofiera (Caremark Homecare), and Gil Honigfeld and Peter Jager (Sandoz) for their comments and suggestions.
Source Information
From the Department of Psychiatry, Hillside Hospital, Division of Long Island Jewish Medical Center, Glen Oaks, N.Y. (J.M.J.A., J.A.L., A.Z.S.); the Department of Psychiatry, Albert Einstein College of Medicine, Bronx, N.Y. (J.M.J.A., J.A.L., A.Z.S.); and Sandoz Pharmaceuticals, East Hanover, N.J. (J.L.S., J.A.S.).
Address reprint requests to Dr. Alvir at Hillside Hospital, Long Island Jewish Medical Ctr., 75-59 263rd St., Glen Oaks, NY 11004.
- References
References
1
Burki HR ,Sayers AC ,Ruch W ,Asper H . Clozapine and the dopamine hypothesis of schizophrenia: a critical appraisal. Pharmacopsychiatry 1975;8:115-121
CrossRef2
Chiodo LA ,Bunney BS . Typical and atypical neuroleptics: differential effects of chronic administration on the activity of A9 and A10 midbrain dopaminergic neurons. J Neurosci 1983;3:1067-10193
Ljungberg T ,Ungerstedt U . Classification of neuroleptic drugs according to their ability to inhibit apomorphine-induced locomotion and gnawing: evidence for two different mechanisms of action. Psychopharmacology (Berl) 1978;56:239-247
CrossRef | Web of Science | Medline4
Sayers AC ,Burki HR ,Ruch W ,Asper H . Neuroleptic-induced hypersensitivity of striatal dopamine receptors in the rat as a model of tardive dyskinesias: effects of clozapine, haloperidol, loxapine and chlorpromazine. Psychopharmacologia 1975;41:97-104
CrossRef | Web of Science | Medline5
Schmutz J ,Eichenberger E . Clozapine. Chron Drug Discovery 1982;1:39-596
Kane JM ,Cooper TB ,Sachar EJ ,Halpern FS ,Bailine S . Clozapine: plasma levels and prolactin response. Psychopharmacology 1981;73:184-187
CrossRef | Web of Science | Medline7
Kane J ,Honigfeld G ,Singer J ,Meltzer H . Clozapine for the treatment-resistant schizophrenic: a double-blind comparison versus chlorpromazine. Arch Gen Psychiatry 1988;45:789-796
Web of Science | Medline8
Lieberman JA ,Kane J ,Johns CA ,Vital-Herne J . Clozapine: clinical evidence of novel effects. Clin Neuropharmacol 1986;9:Suppl 4:140-141
Web of Science9
Lieberman JA ,Saltz BL ,Johns CA ,Pollack S ,Kane JM . Clozapine effects on tardive dyskinesia. Psychopharmacol Bull 1989;25:57-62
Medline10
Idanpaan-Heikkila J ,Alhava E ,Olkinuora M ,Palva I . Clozapine and agranulocytosis. Lancet 1975;2:611-611
CrossRef | Web of Science | Medline11
Idanpaan-Heikkila J ,Alhava E ,Olkinuora M ,Palva I . Agranulocytosis during treatment with clozapine. Eur J Clin Pharmacol 1977;11:193-198
CrossRef | Web of Science | Medline12
Griffith RW ,Saameli K . Clozapine and agranulocytosis. Lancet 1975;2:657-657
CrossRef | Web of Science | Medline13
Jungi WF ,Fischer J ,Senn HJ , et al. Gehaufte durch Clozapin (Leponex) induzierte Agranulozytosen in der Ostschweiz? Schweiz Med Wochenschr 1977;107:1861-1864
Medline14
Amsler HA ,Teerenhovi L ,Barth E ,Harjula K ,Vuopio P . Agranulocytosis in patients treated with clozapine: a study of the Finnish epidemic. Acta Psychiatr Scand 1977;56:241-248
CrossRef | Web of Science | Medline15
Anderman B ,Griffith RW . Clozapine-induced agranulocytosis: a situation report up to August 1976. Eur J Clin Pharmacol 1977;11:199-201
CrossRef | Web of Science | Medline16
de la Chapelle A ,Kari C ,Nurminen M ,Hernberg S . Clozapine-induced agranulocytosis: a genetic and epidemiologic study. Hum Genet 1977;37:183-194
CrossRef | Web of Science | Medline17
Lieberman JA ,Johns CA ,Kane JM , et al. Clozapine-induced agranulocytosis: non-cross-reactivity with other psychotropic drugs. J Clin Psychiatry 1988;49:271-277
Web of Science | Medline18
Pisciotta AV . A brief review of drug-induced agranulocytosis. J Clin Psychiatry Monogr 1990;8:22-2919
Pisciotta AV ,Konings SA ,Ciesemier LL ,Cronkite CE ,Lieberman JA . Cytotoxic activity in serum of patients with clozapine-induced agranulocytosis. J Lab Clin Med 1992;119:254-266
Medline20
Bastani B ,Alphs LD ,Meltzer HY . Development of the Clozaril Patient Management System. Psychopharmacology (Berl) 1989;99:Suppl:S122-S125
CrossRef | Web of Science | Medline21
Clozaril (clozapine): the atypical antipsychotic. East Hanover, N.J.: Sandoz Pharmaceuticals, 1989.
22
SAS/STAT user's guide, version 6, 4th ed. Vol. 2. Cary, N.C.: SAS Institute, 1989:1027-69.
23
SAS/STAT software: the PHREG procedure, preliminary documentation. Cary, N.C.: SAS Institute, 1991.
24
Fleming TR, Harrington DP. Counting processes and survival analysis. New York: John Wiley, 1991.
25
Gerson SL ,Lieberman JA ,Friedenberg WR ,Lee D ,Marx JJ Jr ,Meltzer H . Polypharmacy and fatal clozapine-associated agranulocytosis. Lancet 1991;338:262-263
CrossRef | Web of Science | Medline26
Hippius H ,Kranig K . Die Agranulocytose unter neuro-psychiatrischer Phenothiazine-Therapie. Arztl Wochenschr 1958;13:501-507
Medline27
Pisciotta AV . Agranulocytosis induced by certain phenothiazine derivates. JAMA 1969;208:1862-1868
CrossRef | Web of Science | Medline28
Lieberman JA ,Yunis J ,Egea E ,Canoso RT ,Kane JM ,Yunis EJ . HLA-B38, DR4, DQw3 and clozapine-induced agranulocytosis in Jewish patients with schizophrenia. Arch Gen Psychiatry 1990;47:945-948
Web of Science | Medline29
Lieberman JA ,Safferman AZ . Clinical profile of clozapine: adverse reactions and agranulocytosis. Psychiatr Q 1992;63:51-70
CrossRef | Medline30
Weide R ,Koppler H ,Heymanns J ,Pfluger K-H ,Havemann K . Successful treatment of clozapine induced agranulocytosis with granulocyte-colony stimulating factor (G-CSF). Br J Haematol 1992;80:557-559
CrossRef | Web of Science | Medline31
Gerson SL ,Gullion G ,Yeh H-S ,Masor C . Granulocyte colony-stimulating factor for clozapine-induced agranulocytosis. Lancet 1992;340:1097-1097
CrossRef | Web of Science | Medline32
Barnas C ,Zwierzina H ,Hummer M ,Sperner-Unterweger B ,Stern A ,Fleischhacker WW . Granulocyte-macrophage colony-stimulating factor (GM-CSF) treatment of clozapine-induced agranulocytosis: a case report. J Clin Psychiatry 1992;53:245-247
Web of Science | Medline
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David J Bowen, Naomi L Lucas, Stanley Braude. (2011) Persistent febrile illness with multi-system organ failure associated with clozapine. Internal Medicine Journalno-no
CrossRef13
Seyed Ahmad Mohajeri, Gholamreza Karimi, Javad Aghamohammadian, Mehdi Rajabnia Khansari. (2011) Clozapine recognition via molecularly imprinted polymers; bulk polymerization versus precipitation method. Journal of Applied Polymer Science 121:6, 3590-3595
CrossRef14
Joseph H. Friedman. 2011. Psychosis in Parkinson's Disease. , 170-182.
CrossRef15
Gianluca Trifirò. (2011) Antipsychotic Drug Use and Community-Acquired Pneumonia. Current Infectious Disease Reports 13:3, 262-268
CrossRef16
Nabilah I. Chowdhury, Gary Remington, James L. Kennedy. (2011) Genetics of Antipsychotic-induced Side Effects and Agranulocytosis. Current Psychiatry Reports 13:2, 156-165
CrossRef17
Jerry R. McKee, Trossie Wall, Jessica Owensby. (2011) Impact of Complete Blood Count Sampling Time Change on White Blood Cell andAbsolute Neutrophil Count Values inClozapine Recipients. Clinical Schizophrenia & Related Psychoses 5:1, 26-32
CrossRef18
Behçet Coşar, Mustafa Ender Taner, Hale Yapc Eser, Ali Ercan Altnöz, Rfat Tarhan. (2011) Does Switching to Another Antipsychotic in Patients With Clozapine-Associated Granulocytopenia Solve the Problem?. Journal of Clinical Psychopharmacology 31:2, 169-173
CrossRef19
Gabriele Masi, Francesca Liboni. (2011) Management of Schizophrenia in Children and Adolescents. Drugs 71:2, 179-208
CrossRef20
Nishant Goyal, Samir Kumar Praharaj, Pushpal Desarkar, Haque Nizamie. (2011) Electroencephalographic Abnormalities in Clozapine-Treated Patients: A Cross-Sectional Study. Psychiatry Investigation 8:4, 372
CrossRef21
John R. Geddes, T. Scott Stroup, Jeffrey A. Lieberman. 2010. Comparative Efficacy and Effectiveness in the Drug Treatment of Schizophrenia. , 525-539.
CrossRef22
Tomislav Majic, Thomas Mell, Bernd Oldenkott, Joachim Behr. (2010) Reversible antipsychotic-associated leukopenia in a patient with splenomegalia. Progress in Neuro-Psychopharmacology and Biological Psychiatry 34:7, 1353-1354
CrossRef23
Covadonga Martínez Díaz-Caneja, Manuel González-Molinier, Javier Conejo Galindo, Miguel Moreno Iñiguez. (2010) Severe Bowel Ischemia Due to Clozapine With Complete Remission After Withdrawal. Journal of Clinical Psychopharmacology 30:4, 463-465
CrossRef24
S. N. Ghaemi, S. B. Thommi. (2010) Death by confounding: bias and mortality. International Journal of Clinical Practice 64:8, 1009-1014
CrossRef25
Annie John, Clement Yeh, Jonathan Boyd, Philip E. Greilich. (2010) Treatment of Refractory Hypotension With Low-Dose Vasopressin in a Patient Receiving Clozapine. Journal of Cardiothoracic and Vascular Anesthesia 24:3, 467-468
CrossRef26
André LeBlanc, Tze Chieh Shiao, René Roy, Lekha Sleno. (2010) Improved detection of reactive metabolites with a bromine-containing glutathione analog using mass defect and isotope pattern matching. Rapid Communications in Mass Spectrometry 24:9, 1241-1250
CrossRef27
Emmanuel Stip, Valérie Tourjman. (2010) Aripiprazole in schizophrenia and schizoaffective disorder: A review. Clinical Therapeutics 32, S3-S20
CrossRef28
Ben Capuano, Ian T. Crosby, Fiona M. McRobb, Anna Podloucka, David A. Taylor, Amelia Vom, Elizabeth Yuriev. (2010) The Synthesis and Preliminary Pharmacological Evaluation of a Series of Substituted 4'-Phenoxypropyl Analogues of the Atypical Antipsychotic Clozapine. Australian Journal of Chemistry 63:1, 116
CrossRef29
Kenny De Wolf, Lieve Balcaen, Elke Van De Walle, Filip Cuyckens, Frank Vanhaecke. (2010) A comparison between HPLC-dynamic reaction cell-ICP-MS and HPLC-sector field-ICP-MS for the detection of glutathione-trapped reactive drug metabolites using clozapine as a model compound. Journal of Analytical Atomic Spectrometry 25:3, 419
CrossRef30
Anand Mattai, Lawrence Fung, Jennifer Bakalar, Gerald Overman, Julia Tossell, Rachel Miller, Judith Rapoport, Nitin Gogtay. (2009) Adjunctive use of lithium carbonate for the management of neutropenia in clozapine-treated children. Human Psychopharmacology: Clinical and Experimental 24:7, 584-589
CrossRef31
M. V. Seeman. (2009) Secondary Effects of Antipsychotics: Women at Greater Risk Than Men. Schizophrenia Bulletin 35:5, 937-948
CrossRef32
F. Stephan, M.-A. Podlipski, J.-M. Kerleau, M. Petit, O. Guillin. (2009) Toxicité médullaire des phénothiazines : à propos d’un cas d’agranulocytose sous chlorpromazine. L'Encéphale 35:2, 173-175
CrossRef33
Johan Fernø, Audun O. Vik-Mo, Goran Jassim, Bjarte Håvik, Kjetil Berge, Silje Skrede, Oddrun A. Gudbrandsen, Jo Waage, Niclas Lunder, Sverre Mørk, Rolf K. Berge, Hugo A. Jørgensen, Vidar M. Steen. (2009) Acute clozapine exposure in vivo induces lipid accumulation and marked sequential changes in the expression of SREBP, PPAR, and LXR target genes in rat liver. Psychopharmacology 203:1, 73-84
CrossRef34
Adib Essali, Nahla Al-Haj Haasan, Chunbo Li, John Rathbone, Adib Essali. 2009. Clozapine versus typical neuroleptic medication for schizophrenia. .
CrossRef35
Schneeweiss, Sebastian, Avorn, Jerry, . (2009) Antipsychotic Agents and Sudden Cardiac Death — How Should We Manage the Risk?. New England Journal of Medicine 360:3, 294-296
Full Text36
Michael Kluge, Andreas Schuld, Alexander Schacht, Hubertus Himmerich, Mira A. Dalal, Peter M. Wehmeier, Dunja Hinze-Selch, Thomas Kraus, Ralf W. Dittmann, Thomas Pollmächer. (2009) Effects of clozapine and olanzapine on cytokine systems are closely linked to weight gain and drug-induced fever. Psychoneuroendocrinology 34:1, 118-128
CrossRef37
Jeffrey K. Aronson, Deirdre Price, Robin E. Ferner. (2009) A Strategy for Regulatory Action When New Adverse Effects of a Licensed Product Emerge. Drug Safety 32:2, 91-98
CrossRef38
José de Leon, Maria J. Arranz, Gualberto Ruaño. (2008) Pharmacogenetic Testing in Psychiatry: A Review of Features and Clinical Realities. Clinics in Laboratory Medicine 28:4, 599-617
CrossRef39
H. Kayir, T. Uzbay. (2008) Effects of Clozapine on Ethanol Withdrawal Syndrome in Rats. Alcohol and Alcoholism 43:6, 619-625
CrossRef40
C. J. Harrington, J. Kreiss. (2008) Successful Use of Clozapine With Immunosuppressive Therapy in a Renal-Transplant Patient. Psychosomatics 49:6, 546-548
CrossRef41
&NA;. (2008) There are important differences between atypical antipsychotics in the relative risk of adverse effects. Drugs & Therapy Perspectives 24:10, 19-22
CrossRef42
Pietro Gareri, Pasquale De Fazio, Emilio Russo, Norma Marigliano, Salvatore De Fazio, Giovambattista De Sarro. (2008) The safety of clozapine in the elderly. Expert Opinion on Drug Safety 7:5, 525-538
CrossRef43
REBECCA BITTER, TAMMIE LEE DEMLER, LEWIS OPLER. (2008) Safety Evaluation of the Concomitant Use of Clozapine and Benzodiazepines: A Retrospective, Cross-Sectional Chart Review. Journal of Psychiatric Practice 14:5, 265-270
CrossRef44
Vishal Madaan, Yael Dvir, Daniel R Wilson. (2008) Child and adolescent schizophrenia: pharmacological approaches. Expert Opinion on Pharmacotherapy 9:12, 2053-2068
CrossRef45
Carolin Opgen-Rhein, Michael Dettling. (2008) Clozapine-induced agranulocytosis and its genetic determinants. Pharmacogenomics 9:8, 1101-1111
CrossRef46
Siegfried Kasper. (2008) Do we need another atypical antipsychotic?. European Neuropsychopharmacology 18, S146-S152
CrossRef47
Karine Goulet, Sylvain Grignon. (2008) Case report: clozapine given in the context of chemotherapy for lung cancer. Psycho-Oncology 17:5, 512-516
CrossRef48
Szu-Ying Wu, Chen-Chung Liu, Ming H. Hsieh. (2008) Successful re-exposure to clozapine following uneventful rechallenge with olanzapine in a patient with neutropenia related to both agents. Progress in Neuro-Psychopharmacology and Biological Psychiatry 32:4, 1089-1090
CrossRef49
Nitin Gogtay, Judith Rapoport. (2008) Clozapine use in children and adolescents. Expert Opinion on Pharmacotherapy 9:3, 459-465
CrossRef50
Paul S. Fishman. (2008) Paradoxical aspects of parkinsonian tremor. Movement Disorders 23:2, 168-173
CrossRef51
Adam Martin, Colmán O'Driscoll, Anthony Samuels. (2008) Clozapine use in a forensic population in a New South Wales prison hospital. Australian and New Zealand Journal of Psychiatry 42:2, 141-146
CrossRef52
Yong Min Ahn, Kunjong Kim, Yong Sik Kim. (2008) Three Cases of Reversible Agranulocytosis after Treatment with Lamotrigine. Psychiatry Investigation 5:2, 121
CrossRef53
Robert J. Flanagan, Louisa Dunk. (2008) Haematological toxicity of drugs used in psychiatry. Human Psychopharmacology: Clinical and Experimental 23:S1, S27-S41
CrossRef54
Ben Capuano, Ian T. Crosby, Edward J. Lloyd, Anna Podloucka, David A. Taylor. (2008) Synthesis and Preliminary Pharmacological Evaluation of 4′-Arylalkyl Analogues of Clozapine. IV. The Effects of Aromaticity and Isosteric Replacement. Australian Journal of Chemistry 61:12, 930
CrossRef55
Roberto Manfredi, Sergio Sabbatani. (2007) Clozapine-related agranulocytosis associated with fever of unknown origin, protective hospitalisation, and multiple adverse events related to the administration of empiric antimicrobial treatment. Pharmacoepidemiology and Drug Safety 16:12, 1285-1289
CrossRef56
Karen A. Mathewson, J.-P. Lindenmayer. (2007) Clozapine and Granulocyte Colony-Stimulating Factor. Journal of Clinical Psychopharmacology 27:6, 714-715
CrossRef57
Siddhartha Annamraju, Brian Sheitman, Susan Saik, Anne Stephenson. (2007) Early Recognition of Clozapine-Induced Myocarditis. Journal of Clinical Psychopharmacology 27:5, 479-483
CrossRef58
ALEXANDRA L. SPORN, ANOOP VERMANI, DEANNA K. GREENSTEIN, AARON J. BOBB, EDGAR P. SPENCER, LIV S. CLASEN, JULIA W. TOSSELL, CATHERINE C. STAYER, PETER A. GOCHMAN, MARGE C. LENANE, JUDITH L. RAPOPORT, NITIN GOGTAY. (2007) Clozapine Treatment of Childhood-Onset Schizophrenia: Evaluation of Effectiveness, Adverse Effects, and Long-Term Outcome. Journal of the American Academy of Child & Adolescent Psychiatry 46:10, 1349-1356
CrossRef59
M Dettling, I Cascorbi, C Opgen-Rhein, R Schaub. (2007) Clozapine-induced agranulocytosis in schizophrenic Caucasians: confirming clues for associations with human leukocyte class I and II antigens. The Pharmacogenomics Journal 7:5, 325-332
CrossRef60
Ikwunga Wonodi, Gloria Reeves, Dana Carmichael, Ilene Verovsky, Matthew T. Avila, Amie Elliott, L. Elliot Hong, Helene M. Adami, Gunvant K. Thaker. (2007) Tardive dyskinesia in children treated with atypical antipsychotic medications. Movement Disorders 22:12, 1777-1782
CrossRef61
San San Thinn, Emily Liew, Athi Lachai May, Hong Choon Chua, Kang Sim. (2007) Reversible Delayed Onset Olanzapine-Associated Leukopenia and Neutropenia in a Clozapine-Naive Patient on Concomitant Depot Antipsychotic. Journal of Clinical Psychopharmacology 27:4, 394-395
CrossRef62
Eilis Kennedy, Ajit Kumar, Soumitra S Datta, Eilis Kennedy. 2007. Antipsychotic medication for childhood-onset schizophrenia. .
CrossRef63
Edeltraut Garbe. (2007) Non-chemotherapy drug-induced agranulocytosis. Expert Opinion on Drug Safety 6:3, 323-335
CrossRef64
Jack Uetrecht. (2007) Idiosyncratic Drug Reactions: Current Understanding. Annual Review of Pharmacology and Toxicology 47:1, 513-539
CrossRef65
Michael Berk, Joanna Fitzsimons, Timothy Lambert, Christos Pantelis, Jayashri Kulkarni, David Castle, Elizabeth W Ryan, Sean Jespersen, Pat McGorry, Gregor Berger, Bill Kuluris, Tom Callaly, Seetal Dodd. (2007) Monitoring the Safe Use of Clozapine. CNS Drugs 21:2, 117-127
CrossRef66
Peter M Haddad, Sonu G Sharma. (2007) Adverse Effects of Atypical Antipsychotics. CNS Drugs 21:11, 911-936
CrossRef67
G. Rajagopal, J. G. Graham, F. F. A. Haut. (2007) Prevention of clozapine-induced granulocytopenia/agranulocytosis with granulocyte-colony stimulating factor (G-CSF) in an intellectually disabled patient with schizophrenia. Journal of Intellectual Disability Research 51:1, 82-85
CrossRef68
M Dominic Beer, Al Aditya Khan, Kalaanithi Ratnajothy. (2006) The effect of clozapine on adverse incidents in a low-secure challenging behaviour unit. Journal of Psychiatric Intensive Care 2:02, 65
CrossRef69
Patrick Waller. (2006) Risk management planning: time to deliver. Pharmacoepidemiology and Drug Safety 15:12, 850-851
CrossRef70
T.K. Sasikumar, D.A. Burnett, H. Zhang, A. Smith-Torhan, A. Fawzi, J.E. Lachowicz. (2006) Hydrazides of clozapine: A new class of D1 dopamine receptor subtype selective antagonists. Bioorganic & Medicinal Chemistry Letters 16:17, 4543-4547
CrossRef71
Byung-Jo Kang, Man-Je Cho, Jung-Tae Oh, Yanghyun Lee, Beang-Jin Chae, Jaewook Ko. (2006) Long-term patient monitoring for clozapine-induced agranulocytosis and neutropenia in Korea: when is it safe to discontinue CPMS?. Human Psychopharmacology: Clinical and Experimental 21:6, 387-391
CrossRef72
Zaheed Husain, Ingrid Almeciga, Julio C. Delgado, Olga P. Clavijo, Januario E. Castro, Viviana Belalcazar, Clara Pinto, Joaquin Zuñiga, Viviana Romero, Edmond J. Yunis. (2006) Increased FasL expression correlates with apoptotic changes in granulocytes cultured with oxidized clozapine. Toxicology and Applied Pharmacology 214:3, 326-334
CrossRef73
Liisa Lahdelma, Kowan Ja Jee, Grigori Joffe, Evgueni Tchoukhine, Jorma Oksanen, Sippy Kaur, Sakari Knuutila, Leif C. Andersson. (2006) Altered Expression of Myeloperoxidase Precursor, Myeloid Cell Nuclear Differentiation Antigen, Fms-related Tyrosine Kinase 3 Ligand, and Antigen CD11A Genes in Leukocytes of Clozapine-treated Schizophrenic Patients. Journal of Clinical Psychopharmacology 26:3, 335-338
CrossRef74
Michael Krebs, Karolina Leopold, Axel Hinzpeter, Martin Schaefer. (2006) Current schizophrenia drugs: efficacy and side effects. Expert Opinion on Pharmacotherapy 7:8, 1005-1016
CrossRef75
Mansour Razminia, Yasser Salem, Sivasubramaniam Devaki, Nilamben Shah, Sandeep Khosla. (2006) Clozapine Induced Myopericarditis. American Journal of Therapeutics 13:3, 274-276
CrossRef76
F.X. López Altimiras, F.J. Muñoz Rodríguez, S. Escoté Llobet. (2006) Leucopenia asociada al uso de risperidona: presentación de un caso y revisión de la literatura. Revista Clínica Española 206:3, 162-163
CrossRef77
2006. Clozapine. , 823-841.
CrossRef78
Caroline H Williams-Gray, Thomas Foltynie, Simon J G Lewis, Roger A Barker. (2006) Cognitive Deficits and Psychosis in Parkinson???s Disease. CNS Drugs 20:6, 477-505
CrossRef79
Luiz Dratcu, Patricia Olowu, Muzafar Hawramy, Charitomeni, Konstantinidou. (2006) Aripiprazole in the acute treatment of male patients with schizophrenia: effectiveness, acceptability, and risks in the inner-city hospital setting. Neuropsychiatric Disease and Treatment 2:2, 191-197
CrossRef80
M. Riedel, N. Müller, M. Strassnig, I. Spellmann, R. R. Engel, R. Musil, S. Dehning, A. Douhet, M. J. Schwarz, H.–J. Möller. (2005) Quetiapine has equivalent efficacy and superior tolerability to risperidone in the treatment of schizophrenia with predominantly negative symptoms. European Archives of Psychiatry and Clinical Neuroscience 255:6, 432-437
CrossRef81
A VANCITTERS. (2005) Evidence-Based Review of Pharmacologic and Nonpharmacologic Treatments for Older Adults with Schizophrenia. Psychiatric Clinics of North America 28:4, 913-939
CrossRef82
Igor Mosyagin, Ingolf Cascorbi, Rainer Schaub, Timo Kr??ger, Michael Dettling. (2005) Drug-Induced Agranulocytosis. Journal of Clinical Psychopharmacology 25:5, 435-440
CrossRef83
Ginny Gerbino-Rosen, David Roofeh, D. Andrew Tompkins, Doug Feryo, Laurie Nusser, Harvey Kranzler, Barbara Napolitano, Anne Frederickson, Inika Henderson, Joe Rhinewine, Sanjiv Kumra. (2005) Hematological Adverse Events in Clozapine-Treated Children and Adolescents. Journal of the American Academy of Child & Adolescent Psychiatry 44:10, 1024-1031
CrossRef84
Joanna Fitzsimons, Michael Berk, Timothy Lambert, Michel Bourin, Seetal Dodd. (2005) A review of clozapine safety. Expert Opinion on Drug Safety 4:4, 731-744
CrossRef85
Celso Arango, Miguel Bernardo. (2005) The effect of quetiapine on aggression and hostility in patients with schizophrenia. Human Psychopharmacology: Clinical and Experimental 20:4, 237-241
CrossRef86
A. Betz, K. Ishiwari, A. Wisniecki, N. Huyn, J. D. Salamone. (2005) Quetiapine (Seroquel) shows a pattern of behavioral effects similar to the atypical antipsychotics clozapine and olanzapine: studies with tremulous jaw movements in rats. Psychopharmacology 179:2, 383-392
CrossRef87
Joyce G. Small, Mary C. Weber, Marietta H. Klapper, Jeffrey J. Kellams. (2005) Rechallenge of Late-Onset Neutropenia With Clozapine. Journal of Clinical Psychopharmacology 25:2, 185-186
CrossRef88
Hasmet A. Hanagasi, Murat Emre. (2005) Treatment of behavioural symptoms and dementia in Parkinson's disease. Fundamental and Clinical Pharmacology 19:2, 133-146
CrossRef89
Jon A. Mukand, Colleen Fitzsimmons, Heidi K. Wennemer, Adriana Carrillo, Chunbo Cai, Kim M. Bailey. (2005) Olanzapine for the treatment of hemiballismus: A case report. Archives of Physical Medicine and Rehabilitation 86:3, 587-590
CrossRef90
Francisco J. de Abajo. (2005) Improving Pharmacovigilance Beyond Spontaneous Reporting. International Journal of Pharmaceutical Medicine 19:4, 209-218
CrossRef91
David Esposito, Fr
d
CrossRef92
Martha Sajatovic, Subramoniam Madhusoodanan, Nicoleta Coconcea. (2005) Managing Bipolar Disorder in the Elderly. Drugs & Aging 22:1, 39-54
CrossRef93
Hubert H. Fernandez, Martha E. Trieschmann, Michael S. Okun. (2005) Rebound psychosis: Effect of discontinuation of antipsychotics in Parkinson's disease. Movement Disorders 20:1, 104-105
CrossRef94
Igor Mosyagin, Michael Dettling, Ivar Roots, Bruno Mueller-Oerlinghausen, Ingolf Cascorbi. (2004) Impact of Myeloperoxidase and NADPH-Oxidase Polymorphisms in Drug-Induced Agranulocytosis. Journal of Clinical Psychopharmacology 24:6, 613-617
CrossRef95
Jennifer Cheng-Shannon, James J. McGough, Caroly Pataki, James T. McCracken. (2004) Second-Generation Antipsychotic Medications in Children and Adolescents. Journal of Child and Adolescent Psychopharmacology 14:3, 372-394
CrossRef96
Mélanie M Ferrerri, Jean-Yves Loze, Frédéric Rouillon, Frédéric Limosin. (2004) Clozapine treatment of a borderline personality disorder with severe self-mutilating behaviours. European Psychiatry 19:3, 177-178
CrossRef97
JLW Bosboom, ECh Wolters. (2004) Psychotic symptoms in Parkinson’s disease: pathophysiology and management. Expert Opinion on Drug Safety 3:3, 209-220
CrossRef98
Stephen Layton, Martin Barbeau. (2004) Generic replacement of clozapine: a simple decision model from a Canadian perspective. Current Medical Research and Opinion 20:4, 453-459
CrossRef99
Yong Min Ahn, Seong Hoon Jeong, Hong Suk Jang, Young Jin Koo, Ung Gu Kang, Kyu Young Lee, Yong Sik Kim. (2004) Experience of maintaining clozapine medication in patients with ???red-alert zone??? neutropenia: long-term follow-up results. International Clinical Psychopharmacology 19:2, 97-101
CrossRef100
Jorge L. Juncos, Vicki J. Roberts, Marian L. Evatt, Rita D. Jewart, Colleen D. Wood, Larry S. Potter, Hann-Chang Jou, Paul P. Yeung. (2004) Quetiapine improves psychotic symptoms and cognition in Parkinson's disease. Movement Disorders 19:1, 29-35
CrossRef101
Istvan Bitter, Martin R.K Dossenbach, Shlomo Brook, Peter D Feldman, Stephen Metcalfe, Carlo A Gagiano, János Füredi, György Bartko, Zoltan Janka, Csaba M Banki, Gabor Kovacs, Alan Breier. (2004) Olanzapine versus clozapine in treatment-resistant or treatment-intolerant schizophrenia. Progress in Neuro-Psychopharmacology and Biological Psychiatry 28:1, 173-180
CrossRef102
Hasmet A. Hanagasi, Basar Bilgic, Hakan Gurvit, Murat Emre. (2004) Clozapine Treatment in Oromandibular Dystonia. Clinical Neuropharmacology 27:2, 84-86
CrossRef103
Janet Romrell, Hubert H Fernandez, Michael S Okun. (2003) Rationale for current therapies in Parkinson’s disease. Expert Opinion on Pharmacotherapy 4:10, 1747-1761
CrossRef104
Nadeem H. Bhanji, Howard C. Margolese, Guy Chouinard, Luc Turnier. (2003) Late-Onset Agranulocytosis in a Patient With Schizophrenia After 17 Months of Clozapine Treatment. Journal of Clinical Psychopharmacology 23:5, 522-523
CrossRef105
Alexandra Sporn, Nitin Gogtay, Roberto Ortiz-Aguayo, Cara Alfaro, Julia Tossell, Marge Lenane, Peter Gochman, Judith L. Rapoport. (2003) Clozapine-Induced Neutropenia in Children: Management with Lithium Carbonate. Journal of Child and Adolescent Psychopharmacology 13:3, 401-404
CrossRef106
Frank Gianfrancesco, Richard White, Ruey-hua Wang, Henry A. Nasrallah. (2003) Antipsychotic-Induced Type 2 Diabetes: Evidence From a Large Health Plan Database. Journal of Clinical Psychopharmacology 23:4, 328-335
CrossRef107
RL Hall, AG Smith, J Guy Edwards. (2003) Haematological safety of antipsychotic drugs. Expert Opinion on Drug Safety 2:4, 395-399
CrossRef108
Hubert H. Fernandez, Martha E. Trieschmann, Monica A. Burke, Carol Jacques, Joseph H. Friedman. (2003) Long-term outcome of quetiapine use for psychosis among parkinsonian patients. Movement Disorders 18:5, 510-514
CrossRef109
Donard S. Dwyer, Xiao-Hong Lu, Ronald J. Bradley. (2003) Cytotoxicity of conventional and atypical antipsychotic drugs in relation to glucose metabolism. Brain Research 971:1, 31-39
CrossRef110
T.P. van Staa, F. Boulton, C. Cooper, A. Hagenbeek, H. Inskip, H.G.M. Leufkens. (2003) Neutropenia and agranulocytosis in England and Wales: Incidence and risk factors. American Journal of Hematology 72:4, 248-254
CrossRef111
Elie Paul Elovic, Ramon Lansang, Yali Li, Joseph H. Ricker. (2003) The Use of Atypical Antipsychotics in Traumatic Brain Injury. Journal of Head Trauma Rehabilitation 18:2, 177-195
CrossRef112
Jean A. Frazier, Louise Glassner Cohen, Leslie Jacobsen, Dale Grothe, James Flood, Ross J. Baldessarini, Stephen Piscitelli, Grace S. Kim, Judith L. Rapoport. (2003) Clozapine Pharmacokinetics in Children and Adolescents with Childhood-Onset Schizophrenia. Journal of Clinical Psychopharmacology 23:1, 87-91
CrossRef113
SARAH B. SCHUR, LIN SIKICH, ROBERT L. FINDLING, RICHARD P. MALONE, M. LYNN CRISMON, ALBERT DERIVAN, JAMES C. MACINTYRE, ELIZABETH PAPPADOPULOS, LAURENCE GREENHILL, NINA SCHOOLER, KIMBERLY VAN ORDEN, PETER S. JENSEN. (2003) Treatment Recommendations for the Use of Antipsychotics for Aggressive Youth (TRAAY). Part I: A Review. Journal of the American Academy of Child & Adolescent Psychiatry 42:2, 132-144
CrossRef114
C. Anthony Altar, Arnold R. Martin, Andrew Thurkauf. 2003. Antipsychotic Agents. .
CrossRef115
David Esposito, Jérémie Aouillé, Frédéric Rouillon, Frédéric Limosin. (2003) Morning pseudoneutropenia during clozapine treatment. World Journal of Biological Psychiatry 4:4, 192-194
CrossRef116
Michael J. Reinstein, John G. Sonnenberg, Sangarapillai C. Mohan, Maxim A. Chasanov, Lynne E. Jones. (2003) Use of Quetiapine to Manage Patients Who Experienced Adverse Effects with Clozapine. Clinical Drug Investigation 23:1, 63-67
CrossRef117
Elizabeth A Pappadopulos, Sonja E Siennick, Peter S Jensen. (2003) Antipsychotics for aggressive adolescents: barriers tobest practice. Expert Review of Neurotherapeutics 3:1, 85-98
CrossRef118
Peter J Carey. (2003) Drug-Induced Myelosuppression. Drug Safety 26:10, 691-706
CrossRef119
Martha Sajatovic. (2002) Treatment of bipolar disorder in older adults. International Journal of Geriatric Psychiatry 17:9, 865-873
CrossRef120
Jeremy A. Sable, Dilip V. Jeste. (2002) Antipsychotic treatment for late-life schizophrenia. Current Psychiatry Reports 4:4, 299-306
CrossRef121
Christian Otte, Dieter Naber. (2002) Atypical antipsychotics in the treatment of schizophrenic patients. Expert Review of Neurotherapeutics 2:3, 355-362
CrossRef122
Lionella Palego, Luciano Biondi, Gino Giannaccini, Nannina Sarno, Simona Elmi, Antonio Ciapparelli, Giovanni Battista Cassano, Antonio Lucacchini, Claudia Martini, Liliana Dell'Osso. (2002) Clozapine, norclozapine plasma levels, their sum and ratio in 50 psychotic patients. Progress in Neuro-Psychopharmacology and Biological Psychiatry 26:3, 473-480
CrossRef123
&NA;. (2002) II The usefulness of the second-generation antipsychotic medications. Current Opinion in Psychiatry 15, S7-S16
CrossRef124
J. M. Langosch, M. R. Trimble. (2002) Epilepsy, psychosis and clozapine. Human Psychopharmacology: Clinical and Experimental 17:2, 115-119
CrossRef125
Andrew J. Cutler, Jeffrey M. Goldstein, John A. Tumas. (2002) Dosing and switching strategies for quetiapine fumarate. Clinical Therapeutics 24:2, 209-222
CrossRef126
Geddes, John, . (2002) Prevention of Relapse in Schizophrenia. New England Journal of Medicine 346:1, 56-58
Full Text127
Daniel Tarsy, Ross J. Baldessarini, Frank I. Tarazi. (2002) Effects of Newer Antipsychotics on Extrapyramidal Function. CNS Drugs 16:1, 23-45
CrossRef128
Jonathan M. Meyer. (2001) Individual Changes in Clozapine Levels After Smoking Cessation: Results and a Predictive Model. Journal of Clinical Psychopharmacology 21:6, 569-574
CrossRef129
Herbert Y Meltzer, Tomiki Sumiyoshi, Karu Jayathilake. (2001) Melperone in the treatment of neuroleptic-resistant schizophrenia. Psychiatry Research 105:3, 201-209
CrossRef130
Hui Tie, Bruce D. Walker, Cameron B. Singleton, Jane A. Bursill, Ken R. Wyse, Terry J. Campbell, Stella M. Valenzuela, Samuel N. Breit. (2001) Clozapine and Sudden Death. Journal of Clinical Psychopharmacology 21:6, 630-632
CrossRef131
Michel Bourin, Bernard Guitton, Eric Dailly, Pascale Hery, Pascale Jolliet. (2001) A follow-up study of a population of schizophrenic patients treated with clozapine. Progress in Neuro-Psychopharmacology and Biological Psychiatry 25:8, 1481-1495
CrossRef132
Lut Tamam, Emel Kulan, Nurgul Ozpoyraz. (2001) Late onset neutropenia during clozapine treatment. Psychiatry and Clinical Neurosciences 55:5, 547-548
CrossRef133
Eric S. Molho, Stewart A. Factor. (2001) Parkinson’s disease: The treatment of drug-induced hallucinations and psychosis. Current Neurology and Neuroscience Reports 1:4, 320-328
CrossRef134
S Giménez-Roldán, D Mateo, E Navarro, M.M Ginés. (2001) Efficacy and safety of clozapine and olanzapine: an open-label study comparing two groups of Parkinson's disease patients with dopaminergic-induced psychosis. Parkinsonism & Related Disorders 7:2, 121-127
CrossRef135
A. Kodesh, B. Finkel, A. G. Lerner, G. Kretzmer, M. Sigal. (2001) Dose-dependent olanzapine-associated leukopenia: three case reports. International Clinical Psychopharmacology 16:2, 117-119
CrossRef136
M. Dettling, R. T. Schaub, B. Mueller-Oerlinghausen, I. Roots, I. Cascorbi. (2001) Further evidence of human leukocyte antigen-encoded susceptibility to clozapine-induced agranulocytosis independent of ancestry. Pharmacogenetics 11:2, 135-141
CrossRef137
Janet M. Mullington, Dunja Hinze-Selch, Thomas Pollmächer. (2001) Mediators of Inflammation and Their Interaction with Sleep. Annals of the New York Academy of Sciences 933:1, 201-210
CrossRef138
Liisa Lahdelma, Antti Ahokas, Leif C. Andersson, Jaana Suvisaari, Iiris Hovatta, Matti O. Huttunen, Saija Koskimies. (2001) Human Leukocyte Antigen-A1 Predicts a Good Therapeutic Response to Clozapine With a Low Risk of Agranulocytosis in Patients With Schizophrenia. Journal of Clinical Psychopharmacology 21:1, 4-7
CrossRef139
Ole V. Olesen, Birgit Poulsen, Kristian Linnet. (2001) Fully Automated On-Line Determination of Olanzapine in Serum for Routine Therapeutic Drug Monitoring. Therapeutic Drug Monitoring 23:1, 51-55
CrossRef140
Ron Bell, Ron Bell, Andrew Mclaren, David Copolov. (2001) How reliable are reported plasma clozapine levels?. Australian and New Zealand Journal of Psychiatry 35:4, 468-473
CrossRef141
Stewart A. Factor, Joseph H. Friedman, Margaret C. Lannon, David Oakes, Keith Bourgeois, . (2001) Clozapine for the treatment of drug-induced psychosis in Parkinson's disease: Results of the 12 week open label extension in the PSYCLOPS trial. Movement Disorders 16:1, 135-139
CrossRef142
A K Malhotra. (2001) Pharmacogenomics and schizophrenia: clinical implications. The Pharmacogenomics Journal 1:2, 109-114
CrossRef143
Marek Jauss, Johannes Pantel, Egon Werle, Johannes Schröder. (2000) G-CSF plasma levels in clozapine-induced neutropenia. Biological Psychiatry 48:11, 1113-1115
CrossRef144
Raymond C Love, Matthew W Nelson. (2000) Pharmacology and clinical experience with risperidone. Expert Opinion on Pharmacotherapy 1:7, 1441-1453
CrossRef145
Thomas Pollmächer, Monika Haack, Andreas Schuld, Thomas Kraus, Dunja Hinze-Selch. (2000) Effects of antipsychotic drugs on cytokine networks. Journal of Psychiatric Research 34:6, 369-382
CrossRef146
Herbert Y. Meltzer, Ravi Anand, Larry Alphs. (2000) Reducing Suicide Risk in Schizophrenia. CNS Drugs 14:5, 355-365
CrossRef147
Pierre N. Tariot, Carl Salzman, Paul P. Yeung, Joseph Pute, Ihor W. Rak. (2000) Long-term use of quetiapine in elderly patients with psychotic disorders. Clinical Therapeutics 22:9, 1068-1084
CrossRef148
Kristian Wahlbeck, Maxim Cheine, Katinka Tuisku, Antti Ahokas, Grigori Joffe, Ranan Rimón. (2000) Risperidone versus clozapine in treatment-resistant schizophrenia: A randomized pilot study. Progress in Neuro-Psychopharmacology and Biological Psychiatry 24:6, 911-922
CrossRef149
Helmut Remschmidt, Christian Fleischhaker, Klaus Hennighausen, Eberhard Schulz. (2000) Management of Schizophrenia in Children and Adolescents. Paediatric Drugs 2:4, 253-262
CrossRef150
J. Fang. (2000) Metabolism of clozapine by rat brain: the role of flavin-containing monooxygenase (FMO) and cytochrome P450 enzymes. European Journal of Drug Metabolism and Pharmacokinetics 25:2, 109-114
CrossRef151
Joseph H. Friedman, Stewart A. Factor. (2000) Atypical antipsychotics in the treatment of drug-induced psychosis in Parkinson's disease. Movement Disorders 15:2, 201-211
CrossRef152
Martha Sajatovic, Subramoniam Madhusoodanan, Peter Buckley. (2000) Schizophrenia in the Elderly. CNS Drugs 13:2, 103-115
CrossRef153
Jens G Kilian, Kristin Kerr, Christopher Lawrence, David S Celermajer. (1999) Myocarditis and cardiomyopathy associated with clozapine. The Lancet 354:9193, 1841-1845
CrossRef154
Kristian Wahlbeck, Maxim V Cheine, Adib Essali, Kristian Wahlbeck. 1999. Clozapine versus typical neuroleptic medication for schizophrenia. .
CrossRef155
Wassilios Meissner, Tamara Schmidt, Andreas Kupsch, Thomas Trottenberg, Thomas Lempert. (1999) Reversible leucopenia related to olanzapine. Movement Disorders 14:5, 872-873
CrossRef156
Francesco Benedetti, Roberto Cavallaro, Enrico Smeraldi. (1999) Olanzapine-induced neutropenia after clozapine-induced neutropenia. The Lancet 354:9178, 567
CrossRef157
Yiu-Chung Chan, Stephen F. Pariser, Gayle Neufeld. (1999) Atypical Antipsychotics in Older Adults. Pharmacotherapy 19:7, 811-822
CrossRef158
Gabriella Facciolà, Angela Avenoso, Maria G. Scordo, Aldo G. Madia, Andrea Ventimiglia, Emilio Perucca, Edoardo Spina. (1999) Small Effects of Valproic Acid on the Plasma Concentrations of Clozapine and its Major Metabolites in Patients With Schizophrenic or Affective Disorders. Therapeutic Drug Monitoring 21:3, 341
CrossRef159
Roberto Ceravolo, Stefania Salvetti, Paola Piccini, Claudio Lucetti, Gianna Gambaccini, Ubaldo Bonuccelli. (1999) Acute and chronic effects of clozapine in essential tremor. Movement Disorders 14:3, 468-472
CrossRef160
M. Percudani, G. Fattore, J. Galletta, P. L. Mita, A. Contini, A. C. Altamura. (1999) Health care costs of therapy-refractory schizophrenic patients treated with clozapine: a study in a community psychiatric service in Italy. Acta Psychiatrica Scandinavica 99:4, 274-280
CrossRef161
The Parkinson Study Group. (1999) Low-Dose Clozapine for the Treatment of Drug-Induced Psychosis in Parkinson's Disease. New England Journal of Medicine 340:10, 757-763
Full Text162
Campbell, Young, Bateman, Smith, Thomas. (1999) The use of atypical antipsychotics in the management of schizophrenia. British Journal of Clinical Pharmacology 47:1, 13-22
CrossRef163
Hubert H. Fernandez, Raymon Durso. (1998) Clozapine for dopaminergic-induced paraphilias in Parkinson's disease. Movement Disorders 13:3, 597-598
CrossRef164
M.M. van der Klauw, J.H.P. Wilson, B.H.Ch. Stricker. (1998) Drug-associated agranulocytosis: 20 years of reporting in The Netherlands (1974–1994). American Journal of Hematology 57:3, 206-211
CrossRef165
Andreas A.B. Joos, Udo G. Frank, Wolfgang P. Kaschka. (1998) Pharmacokinetic Interaction of Clozapine and Rifampicin in a Forensic Patient With an Atypical Mycobacterial Infection. Journal of Clinical Psychopharmacology 18:1, 83-85
CrossRef166
JAYANTHI KRISHNAMOORTHY, BRYAN H. KING. (1998) Open-Label Olanzapine Treatment in Five Preadolescent Children. Journal of Child and Adolescent Psychopharmacology 8:2, 107-113
CrossRef167
S Galderisi, P Bucci. (1998) The Italian Clozapine System (ICLOS) for treatment monitoring: more than 2 years of experience. European Psychiatry 13:1, 52
CrossRef168
J. Rudolf, M. Grond, M. Neveling, W. -D. Heiss. (1997) Clozapine-induced agranulocytosis and thrombopenia in a patient with dopaminergic psychosis. Journal of Neural Transmission 104:11-12, 1305-1311
CrossRef169
John M Kane, Carol A Tamminga. (1997) Sertindole (Serdolect): preclinical and clinical findings of a new atypical antipsychotic. Expert Opinion on Investigational Drugs 6:11, 1729-1741
CrossRef170
Rosenheck, Robert, Cramer, Joyce, Xu, Weichun, Thomas, Jonathan, Henderson, William, Frisman, Linda, Fye, Carol, Charney, Dennis, . (1997) A Comparison of Clozapine and Haloperidol in Hospitalized Patients with Refractory Schizophrenia. New England Journal of Medicine 337:12, 809-815
Full Text171
B. Frimat, B. Gressier, P. Odou, C. Brunet, T. Dine, M. Luycky, M. Cazin, JC Cazin. (1997) Metabolism of clozapine by human neutrophils: evidence for a specific oxidation of clozapine by the myeloperoxidase system with inhibition of enzymatic chlorination cycle. Fundamental & Clinical Pharmacology 11:3, 267-274
CrossRef172
JORGE L. ARMENTEROS, AGNES H. WHITAKER, MICHAEL. WELIKSON, DEBORAH J. STEDGE, JACK GORMAN. (1997) Risperidone in Adolescents With Schizophrenia: An Open Pilot Study. Journal of the American Academy of Child & Adolescent Psychiatry 36:5, 694-700
CrossRef173
Anand Kanjolia, Jon M. Valigorsky, Ma. Lourdes Joson-Pasion. (1997) Clozaril-induced lupus anticoagulant. American Journal of Hematology 54:4, 345-346
CrossRef174
Tariq Mahmood, Mike Devlin, Trevor Silverstone. (1997) Clozapine in the management of bipolar and schizoaffective manic episodes resistant to standard treatment. Australian and New Zealand Journal of Psychiatry 31:3, 424-426
CrossRef175
Ray Chatterton. (1997) Eosinophilia after commencement of clozapine treatment. Australian and New Zealand Journal of Psychiatry 31:6, 874-876
CrossRef176
STACY C. EDGE, JOHN S. MARKOWITZ, C. LINDSAY DEVANE. (1997) Clozapine Drug-Drug Interactions: A Review of the Literature. Human Psychopharmacology: Clinical and Experimental 12:1, 5-20
CrossRef177
Laurence Herst, Geoff Powell. (1997) Is clozapine safe in the elderly?. Australian and New Zealand Journal of Psychiatry 31:3, 411-417
CrossRef178
Terry Rabinowitz, Frances R. Frankenburg, Franca Centorrino, Judith Kando. (1996) The effect of clozapine on saliva flow rate: A pilot study. Biological Psychiatry 40:11, 1132-1134
CrossRef179
P. Auzou, C. Özsancak, D. Hannequin, N. Moore, P. Augustin. (1996) Clozapine for the treatment of psychosis in Parkinson's disease: a review. Acta Neurologica Scandinavica 94:5, 329-336
CrossRef180
Thomas Pollmacher, Dunja Hinze-Selch, Janet Mullington. (1996) Effects of Clozapine on Plasma Cytokine and Soluble Cytokine Receptor Levels. Journal of Clinical Psychopharmacology 16:5, 403-409
CrossRef181
Rakesh Ranjan, Herbert Y. Meltzer. (1996) Acute and long-term effectiveness of clozapine in treatment-resistant psychotic depression. Biological Psychiatry 40:4, 253-258
CrossRef182
M. Hummer, B. Sperner-Unterweger, M. Kurz, W. W. Fleischhacker, M. Falk, G. Kemmler, H. Oberbauer. (1996) Does eosinophilia predict clozapine induced neutropenia?. Psychopharmacology 124:1-2, 201-204
CrossRef183
Wood, Alastair J.J., , Kane, John Michael, . (1996) Schizophrenia. New England Journal of Medicine 334:1, 34-42
Full Text184
Ron G. Hammock, Stephen R. Schroeder, William R. Levine. (1995) The effect of clozapine on self-injurious behavior. Journal of Autism and Developmental Disorders 25:6, 611-626
CrossRef185
W.W. Fleischhacker. (1995) New drugs for the treatment of schizophrenic patients. Acta Psychiatrica Scandinavica 92, 24-30
CrossRef186
Linda A. Linday, &NA; Pippenger, Alfreda Howard, Jeffrey A. Lieberman. (1995) Free Radical Scavenging Enzyme Activity and Related Trace Metals in Clozapine-Induced Agranulocytosis. Journal of Clinical Psychopharmacology 15:5, 353-360
CrossRef187
Anand Popli, Ronald Pies. (1995) Clozapine and Leukocytosis. Journal of Clinical Psychopharmacology 15:4, 286-287
CrossRef188
Louis F. Fabre, Lisa Arvanitis, Joseph Pultz, Vicki M. Jones, Jeffrey B. Malick, Victor B. Slotnick. (1995) ICI 204,636, a novel, atypical antipsychotic: early indication of safety and efficacy in patients with chronic and subchronic schizophrenia. Clinical Therapeutics 17:3, 366-378
CrossRef189
K. N. Roy Chengappa, Robert W. Baker, Carlo Sirri. (1995) The Successful Use of Clozapine in Ameliorating Severe Self Mutilation In A Patient With Borderline Personality Disorder. Journal of Personality Disorders 9:1, 76-82
CrossRef190
Raz Gross, Daniela Amital, Leonardo Pantoni, Domenico Inzitari. (1995) Letters to the editor. Acta Neurologica Scandinavica 91:3, 225-225
CrossRef191
Peter F Buckley, Otto Kausch, Gretchen Gardner. (1995) Clozapine treatment of schizophrenia: implications for forensic psychiatry. Journal of Clinical Forensic Medicine 2:1, 9-16
CrossRef192
O. V. Olesen, K. Thomsen, P. N. Jensen, R. Rosenberg, C. H. Wulff, N. -A. Rasmussen, C. Refshammer, M. Bysted, J. Sørensen, J. Christensen. (1995) Clozapine serum levels and side effects during steady state treatment of schizophrenic patients: a cross-sectional study. Psychopharmacology 117:3, 371-378
CrossRef193
HY Meltzer. (1995) Multiple-outcome criteria in schizophrenia: an overview of outcome with clozapine. European Psychiatry 10, 19s-25s
CrossRef194
Alan Breier. (1995) The management of treatment-resistant schizophrenia. Current Opinion in Psychiatry 8:1, 41-44
CrossRef195
Stephen R. Schroeder, Ron G. Hammock, James A. Mulick, Johannes Rojahn, Philip Walson, Will Fernald, Patricia Meinhold, Geeta Saphare. (1995) Clinical trials of D1 and D2 dopamine modulating drugs and self-injury in mental retardation and developmental disability. Mental Retardation and Developmental Disabilities Research Reviews 1:2, 120-129
CrossRef196
MIGUEL W. MANDOKI. (1995) Risperidone Treatment of Children and Adolescents: Increased Risk of Extrapyramidal Side Effects?. Journal of Child and Adolescent Psychopharmacology 5:1, 49-67
CrossRef197
Herbert Y. Meltzer, Myung A. Lee, Rakesh Ranjan. (1994) Recent advances in the pharmacotherapy of schxzophrenia. Acta Psychiatrica Scandinavica 90:s384, 95-101
CrossRef198
P. N. GONSKI. (1994) The use of Clozapine in Parkinson's disease. Australian and New Zealand Journal of Medicine 24:5, 585-585
CrossRef199
JEAN A. FRAZIER, CHARLES T. GORDON, KATHLEEN McKENNA, MARGE C. LENANE, DEBBIE JIH, JUDITH L. RAPOPORT. (1994) An Open Trial of Clozapine in 11 Adolescents with Childhood-Onset Schizophrenia. Journal of the American Academy of Child & Adolescent Psychiatry 33:5, 658-663
CrossRef200
LESLIE K. JACOBSEN, MARK C. WALKER, JAMES E. EDWARDS, PHILLIP B. CHAPPELL, JOSEPH L. WOOLSTON. (1994) Clozapine in the Treatment of a Young Adolescent with Schizophrenia. Journal of the American Academy of Child & Adolescent Psychiatry 33:5, 645-650
CrossRef201
Stanton L. Gerson, Cheryl Arce, Herbert Y. Meltzer. (1994) N-desmethylclozapine: a clozapine metabolite that suppresses haemopoiesis. British Journal of Haematology 86:3, 555-561
CrossRef202
James P. Bennett, Elke R. Landow, Susan Dietrich, Lori A. Schuh. (1994) Suppression of dyskinesias in advanced Parkinson's disease: Moderate daily clozapine doses provide long-term dyskinesia reduction. Movement Disorders 9:4, 409-414
CrossRef203
HELMUT REMSCHMIDT, EBERHARD SCHULZ, P.D. MATTHIAS MARTIN. (1994) An Open Trial of Clozapine in Thirty-Six Adolescents with Schizophrenia. Journal of Child and Adolescent Psychopharmacology 4:1, 31-41
CrossRef204
Judith L. Rapoport. (1994) Clozapine and Child Psychiatry. Journal of Child and Adolescent Psychopharmacology 4:1, 1-3
CrossRef205
Benoit H. Mulsant, Samuel Gershon. (1993) Neuroleptics in the treatment of psychosis in late life: A rational approach. International Journal of Geriatric Psychiatry 8:12, 979-992
CrossRef206
Gerson, Stanton L., . (1993) Clozapine -- Deciphering the Risks. New England Journal of Medicine 329:3, 204-205
Full Text207
&NA;. (1993) Clozapine. Reactions Weekly &NA;:461, 6
CrossRef
