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Clozapine treatment of schizophrenia.

SELECTED CASE A 27-year-old woman was admitted to the National Institutes of Health Clinical Center, Bethesda, Md, for inpatient research protocol for schizophrenia. She first experienced behavioral disturbances at 13 years of age when she became withdrawn and isolated from friends and family. She reported auditory hallucinations for the first time at 16 years and developed delusions of control and persecution over ensuing months. Suicidal ruminations culminated in a serious suicide attempt and her first hospitalization at the age of 17 years. Although standard antipsychotic drugs reduced her delusions, the patient remained socially isolated and had symptom exacerbation when under stress. She discontinued antipsychotic drug treatment because of adverse effects on several occasions; in each case, she became acutely psychotic. Prior to her admission to the National Institute of Mental Health, she was hospitalized 15 times, including several hospitalizations mandated by the court because of risk to herself and to