ArticleCNS spectrums2014
Clozapine: an effective treatment for seriously violent and psychopathic men with antisocial personality disorder in a UK high-security hospital.
Article in CNS spectrums, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.
- The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the treatment of adolescent sexual offenders with paraphilic disorders.The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry · 2016Guideline
- The prevalence of antipsychotic polypharmacy and its associations with violent behaviors among forensic psychiatry patients.BMC psychiatry · 2026Article
- Low-Dose Clozapine Reduces Aggression in Violent Substance Use Disorder Patients at a Secure Rehabilitation Center.Case reports in psychiatry · 2025Article
- Psychopathy is a neglected public health problem.Frontiers in psychiatry · 2025Article
- Clozapine for Treatment-Refractory Aggressive Behavior.The Psychiatric quarterly · 2021Article
- Pharmacotherapy of Primary Impulsive Aggression in Violent Criminal Offenders.Frontiers in psychology · 2021Review
- Clozapine re-challenge and initiation following neutropenia: a review and case series of 14 patients in a high-secure forensic hospital.Therapeutic advances in psychopharmacology · 2021Article
- Clozapine in the Treatment of Aggression in Conduct Disorder in Children and Adolescents: A Randomized, Double-blind, Controlled Trial.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2019Article
- [Standards for treatment in forensic committment according to § 63 and § 64 of the German criminal code : Interdisciplinary task force of the DGPPN].Der Nervenarzt · 2017Review
- Disrupted functional connectome in antisocial personality disorder.Brain imaging and behavior · 2017Article
- Effectiveness of paliperidone depot injection in seriously violent men with comorbid schizophrenia and dissocial personality disorder in a UK high-security hospital.Therapeutic advances in psychopharmacology · 2017Article
- Targeting Serotonin 5-HTAggression and violent behaviorArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveA number of studies have demonstrated the anti-aggressive properties of clozapine in schizophrenia and its positive effect in borderline personality disorder. There is no published literature on the treatment of antisocial personality disorder (ASPD) with clozapine. We present a case series of 7 patients with primary ASPD and high psychopathic traits treated with clozapine, having a significant history of serious violence and currently detained in a UK based high-security hospital.
methodsA retrospective review of case notes was carried out to formulate Clinical Global Impression (CGI) scores and record incidents of violence and aggression. Effect on specific symptom domains (cognitive-perceptual, impulsive-behavioural dyscontrol, affective dysregulation) was also noted. Metabolic parameters and serum clozapine levels were also sampled.
resultsAll 7 patients showed significant improvement on clozapine. It was shown to benefit all symptom domains, especially impulsive behavioral dyscontrol and anger. The number of violent incidents committed by 6 of the 7 patients reduced significantly, and all patients' risk of violence reduced. Clozapine serum levels for 6 of the 7 patients were in the range 150-350 ng/mL.
conclusionClozapine is of benefit in reducing the clinical severity of ASPD. It improved all symptom domains, especially impulsive-behavioral dyscontrol and anger, and reduced levels of aggression and violence, especially at lower doses (serum levels <350 ng/m). To our knowledge, this is the first account of clozapine treatment in patients with ASPD and high psychopathy.
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