Clozapine (Clozaril) reduces suicide attempts in patients with schizophrenia and schizoaffective disorder, according to the results of a multicenter randomized trial published in the January issue of the Archives of General Psychiatry.
The investigators report that this is the first time that pharmacologic therapy has been demonstrated to reduce suicidal behavior. “The risk of suicide attempts in people with schizophrenia and especially schizoaffective disorder is appallingly high,” lead author Herbert Y. Meltzer, MD, from Vanderbilt University in Nashville, Tennessee, says in a news release. “About 30 to 40 percent will make a suicide attempt during their lifetime, and 10 percent of people with schizophrenia will actually die from suicide.”
The International Suicide Prevention Trial (InterSePT) compared the risk of suicidal behavior in 980 patients with schizophrenia or schizoaffective disorder treated with clozapine or olanzapine (Zyprexa). All subjects were considered at high risk for suicide because of previous suicide attempts or current suicidal ideation, and 26.8% were refractory to previous treatment. During the study, all patients were seen weekly for six months and then biweekly for 18 months. After randomization, unmasked clinicians made any interventions needed to prevent suicide attempts.
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