Use of clozapine treating refractory schizophenia in adolescents

Schizophrenia often presents in adolescence but current treatment guidelines are based largely on studies of adults with psychosis. Clozapine is a second-generation antipsychotic typically used for refractory schizophrenia or otherwise psychotic pathology. There are no FDA or manufacturer guidelines for use of clozapine in pediatric population. Nevertheless clozapine is being used as a last line medication to treat refractory schizophrenia in children and adolescents. Case study of 2 adolescent patients, that had been diagnosed with paranoid schizophrenia and were treated with a wide range of antypsychotic medications, both typical and atypical, including clozapine. The duration of untreated illness, of untreated psychosis, the duration of hospitalisation and medications have been analysed in this clinical case review. 1-st case: DUI=6 months; DUP=3 months; 5 different antypsychotic drugs in 6 month period, before starting clozapine max 150 mg per day; has been hospitalised 2 times for 47 days in total. No rehospitalisations within 6 months after prescription of clozapine; 2-nd case: DUI=9 months; DUP=0.25 month; 2 different antypsychotic drugs in 1.5 month period before starting clozapine max 100 mg per day; has been hospitalised once for 75 days total. No rehospitalisation within 6 months after prescription of clozapine; Clozapine is an effective antypsychotic agent in treating refractory schizophrenia in adolescents.