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document
Clozapine versus placebo in Huntington 's disease : a double blind randomised comparative study . OBJECTIVES To establish the effect of the atypical neuroleptic clozapine on chorea , voluntary motor performance , and functional disability in patients with Huntington 's disease . METHODS Thirty three patients with Huntington 's disease participated in a double blind randomised trial . A maximum of 150 mg/day clozapine or placebo equivalent was given for a period of 31 days . Assessments were performed in the week before and at the last day of the trial . Chorea was scored using the abnormal involuntary movement scale ( AIMS ) , the chorea score of the unified Huntington 's disease rating scale ( UHDRS ) , and judgement of video recordings . Voluntary motor performance was assessed using the UHDRS motor scale . Patients and their partners completed a questionnaire regarding functional disability . Twelve patients already used other neuroleptic medication , which was kept unchanged during the trial period . Results of neuroleptic naive and neuroleptic treated patients were analysed separately . RESULTS Clozapine tended to reduce chorea in neuroleptic naive patients only ( AIMS ) ; improvement seemed more pronounced in patients receiving higher doses of clozapine . Other measures of chorea ( UHDRS chorea score , video ratings ) showed no improvement . Clozapine had no beneficial effect on chorea in patients already receiving neuroleptic medication . Voluntary motor performance did not improve with clozapine . Neuroleptic naive patients reported aggravation of functional disability , possibly reflecting the frequent occurrence of side effects . Adverse reactions forced trial termination in six patients and dose reduction in another eight , and consisted mainly of drowsiness , fatigue , anticholinergic symptoms , and walking difficulties . CONCLUSIONS Clozapine has little beneficial effect in patients with Huntington 's disease , although individual patients may tolerate doses high enough to reduce chorea . Because adverse reactions are often encountered , clozapine should be used with restraint in this patient group .
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Intervention_Pharmacological
Clozapine
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Intervention_Control
placebo
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Intervention_Pharmacological
clozapine
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Intervention_Pharmacological
clozapine
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Intervention_Control
or placebo
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Intervention_Pharmacological
Clozapine
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Intervention_Pharmacological
Clozapine
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Intervention_Pharmacological
Clozapine
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Intervention_Pharmacological
clozapine
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Outcome_Physical
chorea
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Outcome_Physical
measures of chorea ( UHDRS chorea score , video ratings )
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Outcome_Physical
chorea
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Outcome_Physical
Voluntary motor performance
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Outcome_Physical
functional disability
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Outcome_Adverse-effects
drowsiness , fatigue , anticholinergic symptoms , and walking difficulties
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Participant_Condition
Huntington 's disease
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Participant_Sample-size
Thirty three