Clozapine for psychosis in Huntington's chorea: a case report

Previous case reports suggest the potential benefits of use of clozapine on psychotic symptoms in Huntington's chorea. Clozapine was administered to a 70 years old female patient admitted in the inpatient unit of the Department of Psychiatry for paranoid delusions, hallucinations, comorbid with Huntington's chorea. Clozapine was administered with increasing regimen ranging from 25 to 200 mg/day after all other medications were discontinued. No other drugs were associated. Clinical evaluation was carried out at days 0, 28, 56, 112, 280 using the PANSS and Psychotic Depression Rating Scale. The clinical improvment was associated with plasma levels of clozapine which have been recognized as in therapeutic ranges by previous studies. Clozapine proved efficient on both positive and negative symptoms as assessed by a decrease of the PANSS ratings (-44 %) between day 0 and day 56 (- 61 %) between day 0 and day 280, and by a decrease of Psychotic Depression ratings (- 43 %) between day 0 and day 56, (- 60 %) between day 0 and day 280. It was also effective on choreiform movements. The clinical improvement was associated with plasma levels of clozapine which have been recognized as in therapeutic ranges by previous studies. A lower daily dose than those classicaly used in schizophrenia was sufficient to obtain efficient treatment.