ArticlePsychogeriatrics : the official journal of the Japanese Psychogeriatric Society2023
Clozapine for the treatment of aggressiveness and agitation in advanced dementia.
Article in Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Adverse Drug Reactions and Drug Interactions in Multimorbid Patients: A Review of Current Evidence.Cureus · 2025Review
- Behavioral and Psychological Symptoms (BPSD) in Alzheimer's Disease (AD): Development and Treatment.Current topics in behavioral neurosciences · 2025Review
- Clozapine for Patients With Intellectual Disabilities: A Case Series Illustrating the Clinical Potentials.Case reports in psychiatry · 2025Article
- Letter to the FDA Proposing Major Changes in the US Clozapine Package Insert Supported by Clozapine Experts Worldwide. Part II: A Review of Fatal Outcomes in US Pharmacovigilance Data and Proposed Changes.Journal of clinical psychopharmacologyArticle
Corrections and comments
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Authors and funding
4 authors.
Funding
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Abstract
backgroundDistressing behavioural symptoms, particularly agitation and aggressiveness, remain a difficult problem in everyday clinical practice in the treatment of multimorbid patients with dementia. Clozapine may be an effective therapeutic alternative in this context.
methodsIn a retrospective study, patients who had a diagnosis of dementia and had been treated in a specialized geriatric psychiatry unit with clozapine between August 2018 and February 2022 were included, and medical records were systematically reviewed. The Clinical Global Impressions Scale was used to assess improvement, and the Pittsburgh Agitation Scale for symptom reduction. In addition, side effects and clinical features were documented in detail.
resultsA total of 31 patients (median age 82 years) were identified with a mean clozapine dose of 47.2 (SD 35.6) mg. A total of 13 patients tolerated clozapine very well, 10 showed tolerable side effects, and in 10 patients side effects were the reason for stopping clozapine. Behavioural symptoms improved significantly, as indicated by the assessment scores.
conclusionsIn summary, clozapine was effective and well tolerated in 23 patients, suggesting that low-dose clozapine may help to alleviate the suffering of difficult-to-treat multimorbid patients with advanced dementia and their caregivers. However, particular attention should be paid to adverse drug reactions, especially in patients with cardiovascular and pulmonary impairment.
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