Clozapine vs haloperidol therapy in elderly chronic schizophrenic inpatients - Preliminary results. A double-blind, cross-over randomized study

We investigated the efficacy of clozapine vs haloperidol in treatment refractory elderly inpatients with schizophrenia in a double-blind cross- over randomized trial. Ten patients were randomly assigned to receive clozapine or haloperidol for 10 weeks; after a washout period, the drugs were switched for another 10 weeks. Patients were assessed weekly with the Brief Psychiatric Rating Scale, Side Effects Profile, Abnormal Involuntary Movement Scale, Simpson-Angus Scale for Extrapyramidal Side Effects, and Scales for the Assessment of Positive and Negative Symptoms. Evaluations performed by analysis of covariance, analysis of variance with repeated measure and paired t-test showed no difference in effect on overall mental status between the medications. Analysis by individual symptoms yielded a significant and rapid improvement in severe depression, exaggerated self-esteem and motor retardation with clozapine. We conclude that clozapine is not more effective than haloperidol in elderly patients with chronic schizophrenia, though it may show some benefit in specific subgroups of patients. Further studies with larger samples and longer protocols are needed to confirm these preliminary findings.