{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T19:59:39Z","timestamp":1793131179214,"version":"4.5.0"},"reference-count":79,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2014,4,3]],"date-time":"2014-04-03T00:00:00Z","timestamp":1396483200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CNS Spectr."],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:sec id=\"S1092852914000157_abs1\" sec-type=\"general\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>A number of studies have demonstrated the anti-aggressive properties of clozapine in schizophrenia and its positive effect in borderline personality disorder. There is no published literature on the treatment of antisocial personality disorder (ASPD) with clozapine. We present a case series of 7 patients with primary ASPD and high psychopathic traits treated with clozapine, having a significant history of serious violence and currently detained in a UK based high-security hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1092852914000157_abs2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of case notes was carried out to formulate Clinical Global Impression (CGI) scores and record incidents of violence and aggression. Effect on specific symptom domains (cognitive-perceptual, impulsive-behavioural dyscontrol, affective dysregulation) was also noted. Metabolic parameters and serum clozapine levels were also sampled.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1092852914000157_abs3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All 7 patients showed significant improvement on clozapine. It was shown to benefit all symptom domains, especially impulsive behavioral dyscontrol and anger. The number of violent incidents committed by 6 of the 7 patients reduced significantly, and all patients\u2019 risk of violence reduced. Clozapine serum levels for 6 of the 7 patients were in the range 150\u2013350 ng\/mL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1092852914000157_abs4\" sec-type=\"conclusion\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Clozapine is of benefit in reducing the clinical severity of ASPD. It improved all symptom domains, especially impulsive-behavioral dyscontrol and anger, and reduced levels of aggression and violence, especially at lower doses (serum levels &lt;350 ng\/m). To our knowledge, this is the first account of clozapine treatment in patients with ASPD and high psychopathy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1092852914000157","type":"journal-article","created":{"date-parts":[[2014,4,3]],"date-time":"2014-04-03T09:04:37Z","timestamp":1396515877000},"page":"391-402","source":"Crossref","is-referenced-by-count":52,"title":["Clozapine: an effective treatment for seriously violent and psychopathic men with antisocial personality disorder in a UK high-security hospital"],"prefix":"10.1017","volume":"19","author":[{"given":"Darcy","family":"Brown","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fintan","family":"Larkin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samrat","family":"Sengupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose L.","family":"Romero-Ureclay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Callum C.","family":"Ross","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morris","family":"Vinestock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mrigendra","family":"Das","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2014,4,3]]},"reference":[{"key":"S1092852914000157_ref59","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2005.09.065"},{"key":"S1092852914000157_ref58","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1176\/ajp.139.6.741","volume":"139","year":"1982","journal-title":"Am J Psychiatry"},{"key":"S1092852914000157_ref57","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-7358(97)00039-1"},{"key":"S1092852914000157_ref56","doi-asserted-by":"publisher","DOI":"10.1017\/S0140525X00061926"},{"key":"S1092852914000157_ref55","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1300424"},{"key":"S1092852914000157_ref54","first-page":"1","volume-title":"Biology of Personality Disorders","year":"1998"},{"key":"S1092852914000157_ref53","doi-asserted-by":"publisher","DOI":"10.1159\/000026542"},{"key":"S1092852914000157_ref52","doi-asserted-by":"publisher","DOI":"10.1007\/s002130000402"},{"key":"S1092852914000157_ref51","doi-asserted-by":"publisher","DOI":"10.1097\/00001756-200104170-00034"},{"key":"S1092852914000157_ref50","doi-asserted-by":"publisher","DOI":"10.1007\/s002130050410"},{"key":"S1092852914000157_ref49","volume-title":"Psychopharmacology of Antipsychotics","year":"1999"},{"key":"S1092852914000157_ref48","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-011-2471-5"},{"key":"S1092852914000157_ref47","doi-asserted-by":"publisher","DOI":"10.1007\/s002130050028"},{"key":"S1092852914000157_ref46","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v59n0103"},{"key":"S1092852914000157_ref45","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","year":"2000"},{"key":"S1092852914000157_ref44","volume-title":"The ICD-10 Classification of Mental and Behavioral Disorders: Clinical Descriptions and Diagnostic Guidelines","volume":"50","year":"1992"},{"key":"S1092852914000157_ref42","first-page":"195","volume":"62","year":"1997","journal-title":"Bull Menninger Clin"},{"key":"S1092852914000157_ref41","first-page":"CD005652","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"S1092852914000157_ref40","doi-asserted-by":"publisher","DOI":"10.1016\/0010-440X(93)90065-C"},{"key":"S1092852914000157_ref38","volume-title":"The Hare Psychopathy Checklist: Screening Version (PCL: SV)","year":"1995"},{"key":"S1092852914000157_ref36","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.63.6.622"},{"key":"S1092852914000157_ref35","first-page":"43","volume":"60","year":"1999","journal-title":"J Clin Psychiatry"},{"key":"S1092852914000157_ref34","first-page":"219","volume":"54","year":"1993","journal-title":"J Clin Psychiatry"},{"key":"S1092852914000157_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/S0920-9964(96)00051-5"},{"key":"S1092852914000157_ref32","doi-asserted-by":"publisher","DOI":"10.1002\/cbm.304"},{"key":"S1092852914000157_ref31","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.52.11.1510"},{"key":"S1092852914000157_ref30","first-page":"1","volume":"53","year":"2002","journal-title":"Schizophr Res"},{"key":"S1092852914000157_ref29","doi-asserted-by":"publisher","DOI":"10.1017\/S146114571100201X"},{"key":"S1092852914000157_ref28","first-page":"607","volume":"23","year":"1995","journal-title":"Bull Am Acad Psychiatry Law"},{"key":"S1092852914000157_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/0010-440X(93)90065-C"},{"key":"S1092852914000157_ref26","doi-asserted-by":"publisher","DOI":"10.1080\/09585180110091994"},{"key":"S1092852914000157_ref25","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v59n0302"},{"key":"S1092852914000157_ref24","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5545.70989"},{"key":"S1092852914000157_ref23","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v60n0710"},{"key":"S1092852914000157_ref22","doi-asserted-by":"publisher","DOI":"10.1185\/03007999709113338"},{"key":"S1092852914000157_ref21","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1988.01800330013001"},{"key":"S1092852914000157_ref20","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.158.4.518"},{"key":"S1092852914000157_ref81","doi-asserted-by":"publisher","DOI":"10.1016\/S0920-9964(98)00163-7"},{"key":"S1092852914000157_ref80","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b293"},{"key":"S1092852914000157_ref19","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2012.709235"},{"key":"S1092852914000157_ref18","doi-asserted-by":"publisher","DOI":"10.1007\/s00210-012-0734-2"},{"key":"S1092852914000157_ref17","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v63n0311"},{"key":"S1092852914000157_ref16","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v64n0602"},{"key":"S1092852914000157_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2003.12.008"},{"key":"S1092852914000157_ref79","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1176\/ajp.143.12.1605","volume":"143","year":"1986","journal-title":"Am J Psychiatry"},{"key":"S1092852914000157_ref14","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v62n1103"},{"key":"S1092852914000157_ref78","doi-asserted-by":"publisher","DOI":"10.1016\/j.pscychresns.2009.03.012"},{"key":"S1092852914000157_ref13","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v65n0704"},{"key":"S1092852914000157_ref77","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2009.01.009"},{"key":"S1092852914000157_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(99)00128-6"},{"key":"S1092852914000157_ref37","journal-title":"Manual for the Revised Psychopathy Checklist (1st ed.)."},{"key":"S1092852914000157_ref76","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbr.2006.01.009"},{"key":"S1092852914000157_ref11","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v69n0617"},{"key":"S1092852914000157_ref75","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.74.7.918"},{"key":"S1092852914000157_ref10","first-page":"104","volume":"65","year":"2004","journal-title":"J Clin Psychiatry"},{"key":"S1092852914000157_ref74","doi-asserted-by":"publisher","DOI":"10.1177\/0269881103017002011"},{"key":"S1092852914000157_ref73","doi-asserted-by":"publisher","DOI":"10.1038\/nn.2510"},{"key":"S1092852914000157_ref72","first-page":"203","volume":"3","year":"1996","journal-title":"Clinical Psychology: Science and Practice"},{"key":"S1092852914000157_ref71","first-page":"105","volume-title":"Psychopathy: Theory, Research and Implications for Society","year":"1998"},{"key":"S1092852914000157_ref70","doi-asserted-by":"publisher","DOI":"10.1192\/apt.10.6.466"},{"key":"S1092852914000157_ref69","doi-asserted-by":"publisher","DOI":"10.3928\/00485713-20120124-06"},{"key":"S1092852914000157_ref68","doi-asserted-by":"publisher","DOI":"10.2165\/00023210-200822080-00005"},{"key":"S1092852914000157_ref67","doi-asserted-by":"publisher","DOI":"10.1192\/apt.10.5.378"},{"key":"S1092852914000157_ref66","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-440X(97)90032-8"},{"key":"S1092852914000157_ref65","first-page":"195","volume":"18","year":"2012","journal-title":"Aggression and Violent Behavior"},{"key":"S1092852914000157_ref64","doi-asserted-by":"publisher","DOI":"10.1176\/appi.neuropsych.15.3.294"},{"key":"S1092852914000157_ref63","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1176\/ajp.154.12.1771","volume":"154","year":"1997","journal-title":"Am J Psychiatry"},{"key":"S1092852914000157_ref62","doi-asserted-by":"publisher","DOI":"10.1016\/0006-3223(90)90660-T"},{"key":"S1092852914000157_ref61","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-002-1139-6"},{"key":"S1092852914000157_ref60","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-010-1851-6"},{"key":"S1092852914000157_ref9","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-837767"},{"key":"S1092852914000157_ref8","first-page":"680194","volume":"2011","year":"2011","journal-title":"Depress Res Treat"},{"key":"S1092852914000157_ref7","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.163.5.833"},{"key":"S1092852914000157_ref6","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v66n1013"},{"key":"S1092852914000157_ref5","doi-asserted-by":"publisher","DOI":"10.3109\/15622970309167910"},{"key":"S1092852914000157_ref4","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v67n0705"},{"key":"S1092852914000157_ref3","first-page":"CD005653","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"S1092852914000157_ref2","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.108.062984"},{"key":"S1092852914000157_ref1","first-page":"14","volume":"71","year":"2010","journal-title":"J Clin Psychiatry"}],"container-title":["CNS Spectrums"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1092852914000157","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,21]],"date-time":"2019-04-21T19:53:30Z","timestamp":1555876410000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1092852914000157\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4,3]]},"references-count":79,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2014,10]]}},"alternative-id":["S1092852914000157"],"URL":"https:\/\/doi.org\/10.1017\/s1092852914000157","relation":{},"ISSN":["1092-8529","2165-6509"],"issn-type":[{"value":"1092-8529","type":"print"},{"value":"2165-6509","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4,3]]}}}