ABSTRACT
Clozapine is an atypical neuroleptic agent given when schizophrenia is resistant to other neuroleptic drugs. Its use is restricted because of the risk of agranulocytosis, which appears in 1% of cases and therefore necessitates frequent WBC counts. We cite the only 2 surveys of the treatment of adolescents with clozapine and report our experience. We treated 7 boys and 6 girls between the ages of 14-17 years (mean 16.6) with clozapine after failure of all other neuroleptic agents tried. Our usual dose was 300 mg/day, for an average of 245 days. In only 2 patients was improvement only partial. In 1 treatment had to be stopped because of symptomatic orthostatic hypotension which appeared 36 hours after the drug was started. In our opinion, clozapine should be considered when severe schizophrenia in adolescents is refractory to other neuroleptic agents, provided the WBC count is monitored.
Subject(s)
Clozapine/therapeutic use , Schizophrenia/drug therapy , Adolescent , Age of Onset , Clozapine/adverse effects , Drug Monitoring , Female , Humans , Hypotension, Orthostatic/chemically induced , Leukocyte Count , MaleABSTRACT
This essay looks at the period of adolescence through the dimension of boundaries and examines how adolescence and boundaries affect one another. During adolescence external physical and internal psychological boundaries are blurred. The climate and milieu are well defined and having the environment provide clear boundaries facilitates the passage of this developmental stage.
Subject(s)
Personality Development , Adolescent , Body Image , Ego , Family , Humans , Psychology, Adolescent , SkinABSTRACT
A patient presented with severe hypophosphataemia that had been precipitated during binge eating. It was corrected by restricting the binges, and by hyperalimentation through a duodenal tube together with intravenous supplementation with sodium phosphate for a short period. Phosphate concentrations should be monitored in patients with severe anorexia complicated by bulimic episodes.
