The history of clozapine and its emergence in the US market

@article{Crilly2007TheHO,
  title={The history of clozapine and its emergence in the US market},
  author={John Crilly},
  journal={History of Psychiatry},
  year={2007},
  volume={18},
  pages={39 - 60}
}
  • J. Crilly
  • Published 1 March 2007
  • Medicine, Psychology
  • History of Psychiatry
Clozapine is known as the first `atypical' medication and is effective in people who have treatment-resistant schizophrenia. Its 1990 emergence in the USA was marked by considerable controversy over its high cost, due in large part to having been both the first new antipsychotic medication to come to market in over a decade and the need for comprehensive safety monitor ing within a decentralized health system. This paper traces the histor y of clozapine's discover y and development in Europe… 

Changes for clozapine monitoring in the United States

Lithium and granulocyte-colony stimulating factor have been used as preventative therapies for patients with a history of clozapineinduced neutropenia upon clozAPine re-challenge.

Clozapine’s critical role in treatment resistant schizophrenia: ensuring both safety and use

Clozapine remains the only treatment indicated in TRS, but it is dramatically underutilized and efforts must be implemented that ensure its use in this population while maximizing safety.

A COMMENTARY ON IMPROVING CLOZAPINE ACCESSIBILITY AND REDUCING TREATMENT COST

  • R. Gurrera
  • Psychology, Medicine
    Psychiatry Research
  • 2021

Clozapine as a Model for Antipsychotic Development

This review discusses the history of clozapine, landmark studies, and its clinical advantages and disadvantages, and highlights some of the advances from pharmacogenetic studies on clozAPine and focuses on studies of clazapine using unbiased approaches such as pharmacogenomics and gene expression profiling.

Clozapine underutilization in treatment-resistant schizophrenia

Clozapine has been shown to provide superior therapeutic benefits and is approved as first-line therapy for TRS, and these benefits include improvement in both positive and negative symptoms, and reduction of suicidal behavior in patients with schizophrenia.

Switching Clozapine to Cariprazine in Three Patients with Persistent Symptoms of Schizophrenia: A Case Series

A case series supports cariprazine as an effective treatment for positive and negative symptoms in patients who failed to adequately respond or poorly tolerated treatment with clozapine, as well as a potential treatment in dual disorders, specifically psychotic disorders and cocaine use disorder.

Where to Position Clozapine: Re-Examining the Evidence

Schizophrenia continues to represent a treatment challenge, with many people demonstrating suboptimal response and poor functional outcome, but in light of existing evidence this warrants re-examination of clozapine.

Clozapine: key discussion points for prescribers.

This article reviews the literature on clozapine in order to measure its potential effectiveness against its adverse effects and ultimately aims to serve as a useful summary for clinicians in their everyday prescribing.

An international clozapine titration guideline to increase its safety and move forward on the route started by German-speaking psychiatrists in the 1960s

It is argued that first-generation antipsychotics [FGAs] were not well studied and should be reconsidered, and a recent international guideline proposed that clozapine metabolism can be measured by the dose needed to reach the minimum therapeutic range of the plasma concentration of 350 ng/ml.
...

References

SHOWING 1-10 OF 59 REFERENCES

A historical perspective of clozapine.

  • H. Hippius
  • Psychology, Medicine
    The Journal of clinical psychiatry
  • 1999
The history of clozapine's development, from its discovery in 1958 to its current position as the "gold standard" therapy for treatment-resistant schizophrenia, is outlined.

The history of clozapine

  • H. Hippius
  • Psychology, Medicine
    Psychopharmacology
  • 2004
It is pointed out that clozapine is not a neuroleptic drug, because it has never shown the typical pharmacological profile or extrapyramidal sideeffects of the so-called classical neuroleptics, such as haloperidol.

Update on the clinical efficacy and side effects of clozapine.

Although CLOZ has proven to be effective in some treatment-refractory schizophrenic patients and to produce relatively few extrapyramidal side effects compared to classical neuroleptics, several issues require further investigation including what defines neuroleptic intolerance, the optimal dose range, and the appropriate duration of a CLOz treatment trial.

A review of clozapine: an antipsychotic for treatment-resistant schizophrenia.

  • P. Stephens
  • Psychology, Medicine
    Comprehensive psychiatry
  • 1990

Access to care: clozapine in the public sector.

  • W. Reid
  • Medicine, Political Science
    Hospital & community psychiatry
  • 1990
Limits on access to the drug by the largest subgroup who need it, the indigent, are causing frustration for patients, their families, physicians, and public-sector mental health systems, and the author discusses these and related issues.

Chlorpromazine; new inhibiting agent for psychomotor excitement and manic states.

The purpose of this article is to report on the experiences with a new drug which seems to possess specific properties for the psychiatric management of excited states.

Clozapine for the treatment-resistant schizophrenic. A double-blind comparison with chlorpromazine.

In this relatively brief study, the apparently increased comparative risk of agranulocytosis requires that the use of clozapine be limited to selected treatment-resistant patients.

Effectiveness of antipsychotic drugs in patients with chronic schizophrenia.

Olanzapine was the most effective in terms of the rates of discontinuation, and the efficacy of the conventional antipsychotic agent perphenazine appeared similar to that of quetiapine, risperidone, and ziprasidone.

Clozapine, chlorpromazine, and placebo in newly hospitalized, acutely schizophrenic patients: a controlled, double-blind comparison.

The data suggest that clozapine in the present population of newly admitted, acutely psychotic schizophrenic individuals, and in the doses employed, was more effective in overall improvement response, discharge rate, and ameliorating discrete symptoms across the different objective rating scales used than was chlorpromazine (Thorazine) hydrochloride.

Therapeutic effects of clozapine

  • C. Leon
  • Psychology
    Acta psychiatrica Scandinavica
  • 1979
Follow‐up evaluations show that the differences between the two groups are persistent, which points in the direction of a better and more sustained therapeutic effect of clozapine over chlorpromazine.
...