1- Objectives: Study the effectiveness of Clozapine in the treatment of prolonged Methamphetamine induced psychotic disorder in substance abuser in addiction treatment centers covered by Iran University of Medical Sciences in Tehran in the first half of 1395 in Tehran who have a history of using drugs.
2- Design: This study is a single –blind clinical trial is to evaluate the efficacy of Clozapine in the treatment of prolonged Methamphetamine induced psychotic disorder in substance abuser referred to addiction treatment centers covered by the University of Medical Sciences in the first half of 1395 in Tehran, who have a history of using drugs and psychiatric diagnosis criteria based on DSM 5 with psychotic disorders caused by Methamphetamine use have been diagnosed (both inpatient and outpatient) setting criteria for psychosis, which lasted 8 weeks of treatment with adequate doses provided to ensure drug compliance (MPR higher than 80) will be designed.
3- Setting and Conduct: Patients will be randomly divided into two groups so that a group Clozapine and other group Olanzapine will receive. Before the start of treatment and as a base or zero-day study, all the patients in terms of symptoms and psychosis severity by questionnaire PANSS, the extrapyramidal side effects on the basis of a scale of extrapyramidal side effects (ESRS) and the Craving on the basis of Craving Beliefs Questionnaire (CBQ) will be evaluated and then follow-up of patients at baseline, the end of the fourth week and eighth week will end.
4- Participants including major eligibility criteria:
Inclusion criteria: 1- A psychotic disorder caused by prolonged use of methamphetamine (more than 1 month psychotic and at the same time cocaine has not); 2- obtaining the informed consent of the patient's guardian; 3- The absence of mental retardation (moderate or severe); 4- Non-organic neurological disease leading to clinical standpoint.
Exclusion criteria: 1- If the loss of white blood cells or neutrophils less than 3,000 is less than 1,500; 2- Unwillingness to continue to participate in the study.
5- Intervention: In the first stage of a medical and drug history the patient will be taken and then medical examination will be done. Trial-by CBC and ECG at baseline for all patients will be performed. For the group treated with Clozapine, based on the standard of care protocol venous blood sampling blood cell count every week until the end of the six week study and measurement of liver enzymes is done with and for the group treated with Olanzapine retesting of intravenous blood samples After six weeks treatment in Start study done to assess liver enzymes. Patients will be selected by convenience sampling method and randomly divided into two groups of 20 by minimizing a group treated with clozapine and olanzapine will be the second group. Randomly listed by age and baseline PANSS score psychosis is in this way that the first 3 patients in the study are randomly placed in two groups and then the new person on the basis of age and score.
6- Main outcome measures: Before the start of treatment and as a base or zero-day study, all the patients in terms of psychosis symptoms by questionnaire PANSS, the extrapyramidal side effects on the basis of a scale of extrapyramidal side effects (ESRS) and the Craving on the basis of Craving Beliefs Questionnaire (CBQ) will be evaluated and then follow-up of patients at baseline, the end of the fourth week and eighth week will end. In addition to the above-mentioned questionnaire, a demographic questionnaire made by the researcher, including age, sex, education, duration of abuse, the age of onset of drug use, the type of substance, other drug use, age at onset of psychotic symptoms at their disposal to complete by patients.