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Acute and chronic effects of clozapine in essential tremor
Author(s) -
Ceravolo Roberto,
Salvetti Stefania,
Piccini Paola,
Lucetti Claudio,
Gambaccini Gianna,
Bonuccelli Ubaldo
Publication year - 1999
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/1531-8257(199905)14:3<468::aid-mds1013>3.0.co;2-m
Subject(s) - clozapine , medicine , sedation , essential tremor , anesthesia , crossover study , placebo , schizophrenia (object oriented programming) , psychiatry , alternative medicine , pathology
Abstract Patients with essential tremor (ET) may not respond to commonly used drugs. Clozapine, an atypical neuroleptic drug, has been reported to improve postural Parkinson's disease tremor clinically resembling ET. The effects of a single dose of 12.5 mg clozapine and placebo were evaluated in a randomized, double‐blind, crossover study in 15 drug‐resistant patients with ET. Patient responders with more than 50% improvement after a single dose of clozapine subsequently received the drug (39 ± 9 mg up to 50 mg) unblinded for a period of 15.8 ± 7.7 months. Tremor was effectively reduced by a single dose of clozapine in 13 of 15 patients (p <0.01). Sedation was the only side effect reported during the clozapine test; however, the time course of sedation and of the antitremor effect were not coincident. A significant reduction of tremor was reported with chronic clozapine treatment (p <0.01) with no tolerance to drug antitremor effect, whereas sedation markedly decreased after 6–7 weeks of therapy. No clozapine‐induced hematologic side effects were observed in our cohort of patients during long‐term treatment. Our results suggest that in selected drug‐resistant ET cases, clozapine should be considered before resorting to neurosurgical options.