Journal of the American Academy of Child & Adolescent Psychiatry
Volume 46, Issue 3 , Pages 423-428 , March 2007

Is There a Role for Clozapine in the Treatment of Children and Adolescents?

,Accepted 28 September 2006.

REFERENCES 

  1. Findling RL, Steiner H, Weller EB. Use of antipsychotics in children and adolescents. J Clin Psychiatry. 2005;66:29–40
  2. Frazier JA, Cohen LG, Jacobsen L, et al. Clozapine serum concentrations in children and adolescents with childhood-onset schizophrenia. J Clin Psychopharm. 2003;23:87–91
  3. Gerbino-Rosen G, Roofeh D, Tompkins DA, et al. Hematological adverse events in clozapine-treated children and adolescents. J Am Acad Child Adolesc Psychiatry. 2005;44:1024–1031
  4. Kowatch RA, Fristad M, Birmaher B, Wagner KD, Findling RL, Hellander M, et al. Treatment guidelines for children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2005;44:213–235
  5. Kranzler HN, Kester HM, Gerbino-Rosen G. Treatment-refractory schizophrenia in children and adolescents: an update on clozapine and other pharmacologic interventions. Child Adolesc Psychiatr Clin N Am. 2006;15:35–159
  6. Kranzler H, Roofeh D, Gerbino-Rosen G, et al. Clozapine: its impact on aggressive behavior among children and adolescents with schizophrenia. J Am Acad Child Adolesc Psychiatry. 2005;44:55–63
  7. Kumra S, Frazier JA, Jacobsen LK, et al. Childhood-onset schizophrenia: a double-blind clozapine-haloperidol comparison. Arch Gen Psychiatry. 1996;53:1090–1097
  8. Shaw P, Sporn A, Gogtay N, et al. Childhood-onset schizophrenia: a double-blind, randomized clozapine-olanzapine comparison. Arch Gen Psychiatry. 2006;63:721–730

 This is a case vignette created to exemplify a complex clinical problem and does not refer to any specific patient.This column aims to discuss practical approaches to everyday issues in pediatric pharmacotherapy. The cases and discussions specifically target aspects of clinical care related to psychopharmacology for which we do not have adequate applicable controlled trials. Given the need to address symptoms in youths with complex, severe, and comorbid disorders, recommendations are likely to be “off label” from the perspective of the U.S. Food and Drug Administration. While it is important that clinicians address psychosocial issues in the evaluation and treatment of their patients, such discussion is beyond the specific scope of this feature. These are not meant to be practice guidelines, but rather examples of thought processes that may go into pharmacotherapy decision making.Disclosure: None of the authors have conducted industry-funded studies of clozapine. Drs. Kumra, Kranzler, and Gerbino-Rosen have conducted studies of clozapine funded by the National Institute of Mental Health, but with study drug donated by Novartis. Dr. Kratochvil was previously a speaker for Novartis and has received grant support from, is a consultant to, and/or member of the speakers' bureaus of Eli Lilly, GlaxoSmithKline, Forest, Shire, Cephalon, Novartis, McNeil, Organon, AstraZeneca, and Pfizer. Dr. Findling has been a consultant to and conducted studies for Novartis, the manufacturer of Clozaril, and receives or has received research support from, acted as a consultant to, and/or served on the speakers' bureaus of Abbott, AstraZeneca, Bristol-Myers Squibb, Celltech-Medeva, Forest, GlaxoSmithKline, Johnson & Johnson, Lilly, New River, Novartis, Otsuka, Pfizer, Sanofi-Aventis, Shire, Solvay, and Wyeth. Dr. Frazier has received research support from, acted as a consultant to, and/or served on the speakers' bureaus of AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Forest Research Institute, Johnson & Johnson Pharmaceutical Research and Development, Otsuka Pharmaceutical Inc., and Pfizer. The other authors have no financial relationships to disclose.

PII: S0890-8567(09)61687-7

doi: 10.1097/chi.0b013e3180ed94e

Journal of the American Academy of Child & Adolescent Psychiatry
Volume 46, Issue 3 , Pages 423-428 , March 2007

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