Clozapine use in Parkinson's disease: a retrospective analysis of a large multicentered clinical experience

Mov Disord. 1998 May;13(3):377-82. doi: 10.1002/mds.870130302.


We conducted a multicentered, retrospective review of clozapine's (CZP) effects on a range of psychiatric, sleep, cognitive, motor, and sensory disorders in Parkinson's disease (PD). Therapeutic outcomes and adverse events were compared with varying prescribing practices at participating sites. The medical records of 172 consecutive PD patients treated with CZP at four movement disorder clinics were reviewed. Low-dose CZP improved psychiatric symptoms of psychosis, anxiety, depression, hypersexuality, sleep disturbance, and akathisia. Tremor, torticollis, limb dystonia, and pain showed modest rates of improvement. Twenty-three percent of patients withdrew as a result of adverse events or treatment failure. Inpatient CZP initiation did not improve therapeutic efficacy, or reduce adverse events or the withdrawal rate. Low-dose CZP in the outpatient setting is generally an effective and well-tolerated treatment for many of the psychiatric, sleep, motor, and sensory disturbances common to late-stage PD.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Ambulatory Care
  • Antiparkinson Agents / adverse effects
  • Antiparkinson Agents / therapeutic use
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / therapeutic use*
  • Clozapine / adverse effects
  • Clozapine / therapeutic use*
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Levodopa / adverse effects
  • Levodopa / therapeutic use
  • Male
  • Middle Aged
  • Neurocognitive Disorders / drug therapy*
  • Neurologic Examination / drug effects
  • Neuropsychological Tests
  • Parkinson Disease / drug therapy*
  • Patient Admission
  • Retrospective Studies
  • Treatment Outcome


  • Antiparkinson Agents
  • Antipsychotic Agents
  • Levodopa
  • Clozapine