Double-blind study of clozapine dose response in chronic schizophrenia.

Objective: This study explored the relative efficacy of three different doses of clozapine.

Method: Fifty patients who met Kane et al.'s criteria for treatment-refractory schizophrenia or schizoaffective disorder were studied.

Does akathisia influence psychopathology in psychotic patients treated with clozapine?

Background: Akathisia has been reported to predict more severe symptoms and poorer treatment response to typical neuroleptics among patients with schizophrenia. Akathisia has also been associated with symptom exacerbation. This study addressed four questions: 1) Does akathisia predict greater severity in global psychopathology? 2) Is this effect global or specific? 3) Does clozapine treatment alter this relationship? 4) Does severity of psychopathology covary with the level of akathisia?

Methods: Akathisia and clinical symptoms were examined in 33 "treatment refractory" schizophrenic patients treated with clozapine across 16 weeks.

Diurnal variability of orofacial dyskinetic movements.

Objective: Instrumental methods to measure tardive dyskinesia (TD) have been introduced in the last few years to try to eliminate the differences in inter-rater reliability. After eliminating variations attributed to the use of different raters, it is clear that TD frequently shows fluctuations in severity contributing to a low test-retest reliability. In the present study the diurnal variability of dyskinetic movements was explored by a computerized technique using digital imaging processing to measure orofacial movements.

Absence of changes in antidiuretic hormone, angiotensin II, and atrial natriuretic peptide with clozapine treatment of polydipsia-hyponatremia: 2 case reports.

Background: Polydipsia-hyponatremia is a poorly understood disorder that causes considerable mortality and morbidity. Hyponatremia in polydipsia-hyponatremia has been attributed to disturbances in antidiuretic hormone (ADH) function. Improvements in polydipsia-hyponatremia during clozapine treatment offered the chance to see if levels of ADH and other hormones associated with osmoregulation changed with improvement in biochemical and clinical measures of polydipsia-hyponatremia.

Clozapine withdrawal resulting in delirium with psychosis: a report of three cases.

Background: Withdrawal symptoms for typical antipsychotics are generally mild, self-limited and do not include development of psychotic symptoms. In contrast, withdrawal symptoms for clozapine can be severe with rapid onset of agitation, abnormal movements, and psychotic symptoms. Different pathophysiologic etiologies have been suggested for these severe symptoms, including dopaminergic supersensitivity and rebound.

Polydipsia and water intoxication in a long-term psychiatric hospital.

This cross-sectional survey attempts to establish the prevalence of polydipsia and water intoxication at a state hospital (N = 360) using staff diagnosis, specific gravity of the urine (SPGU), weight changes, and chart review. There were 150 [42%, 95% confidence interval (CI) 37-47%] patients diagnosed as polydipsic by the staff or by SPGU. At least 93 (26%, CI 21-30%) had primary polydipsia not explained by other causes.

Diurnal and weekly variation of tardive dyskinesia measured by digital image processing.

The diurnal and weekly variability of tardive dyskinesia (TD) was assessed instrumentally by digital image processing. Weekly assessments were obtained in ten patients over a 6-week period. In six of the ten patients, assessments were obtained four times over a single 12-h period.

Treatment of polydipsia and hyponatremia in psychiatric patients. Can clozapine be a new option?

Polydipsia occurs frequently in chronic schizophrenic patients, some of whom develop intermittent hyponatremia. Most therapeutic efforts have tried to control the hyponatremia. Four schizophrenic patients, followed for more than one year, showed improvement on clozapine.

Schizophrenia and smoking: an epidemiological survey in a state hospital.

Objective: The authors sought to determine whether smoking is related to schizophrenia or neuroleptic treatment.

Method: Cigarette smoking was measured in all patients hospitalized at a state hospital (N = 360) and compared in relation to gender and diagnosis (schizophrenic versus nonschizophrenic).

Results: The overall frequency of smoking was 79% (N = 284).

Misidentification syndromes in schizophrenia: case reviews with implications for classification and prevalence.

Misidentification syndromes represent false, delusionally-based identification of self and/or others. These are variants of the Capgras Syndrome. Although the frequency of misidentification syndromes in schizophrenic populations has not yet been established, the authors believe this syndrome is more prevalent than previously described.