New vs. old antipsychotics: the Texas experience.

A study was conducted in Texas state psychiatric facilities of 299 patients with schizophrenia who were taking clozapine, comparing them with 223 matched controls taking traditional neuroleptics. From 12 months before until 54 months after clozapine was begun, hospital bed days and the associated costs were determined for both groups. The clozapine group had appreciably fewer hospital bed days throughout the study period. Substantially fewer clozapine-treated patients than neuroleptic-treated patients required 180 continuous days of hospitalization during the study. By 48 months after initiation of clozapine, hospital inpatient costs were $27,850/patient/year lower in the clozapine group than in the traditional neuroleptic group. Agranulocytosis occurred in < 1% of patients taking clozapine; all recovered quickly. In a separate study, clozapine therapy was shown to produce a 5-fold decrease in the rate of suicide among patients with schizophrenia. Administration of clozapine appears to lower the overall cost of treating schizophrenia by reducing the costs associated with hospitalizations.