Assessment of treatment outcomes and associated factors among patients treated with clozapine at amanuel mental specialized hospital, Addis Ababa, Ethiopia

Treatment with clozapine resulted in significant improvement in clinical and functional outcomes of treatment-resistant schizophrenia and schizoaffective disorder, as well as in tardive dyskinesia. Higher literacy level and severity of illness at onset of treatment showed significant associations with outcome. Clozapine is an atypical or second generation antipsychotic first used in the 1960s. It was withdrawn at first after its use was associated with a number of deaths due to agranulocytosis in Finland in 1975 [1,2]. In 1988 a landmark study demonstrated that the medicine was helpful to patients with schizophrenia who were unresponsive to other medications. Clozapine was then reintroduced into clinical use [3]. Since then, clozapine has been shown to be the only medicine which reduced suicidal behavior in patients with schizophrenia. Clozapine is now the medicine of choice for treatment-resistant schizophrenia [1]. The antipsychotic efficacy and the complete absence of extrapyramidal adverse effects of clozapine have been well documented. The benefit of clozapine for treating patients with treatment-resistant schizophrenia and those who are particularly prone to extrapyramidal adverse effects has been most remarkable [2].