Monday, February 26, 2018

Clozapine reviews

LONDON (Reuters) - Schizophrenia patients given a cheap older drug are less likely to die prematurely than people on newer treatments, despite the older product’s well-known adverse side effects, Finnish researchers said on Monday.

A woman places her hands over her ears in a file image. REUTERS/File

The finding may lead to wider use of clozapine -- sold by Novartis as Clozaril, but also available as a generic -- instead of newer drugs like AstraZeneca’s Seroquel, the current market leader.

Clozapine was the first of a new generation of schizophrenia drugs, known as atypical antipsychotics, but its use has been restricted by health authorities because of safety concerns, and patients taking it require regular blood tests.

Despite this, an analysis of 10 years’ records for 67,000 patients in Finland found that, compared with treatment with the first-generation drug perphenazine, the risk of early death for patients on clozapine was reduced by 26 percent.

By contrast, mortality risk was 41 percent higher for those on Seroquel, known chemically as quetiapine; 34 percent higher with Johnson & Johnson’s Risperdal, or resperidone; and 13 percent higher with Eli Lilly’s Zyprexa, or olanzapine.

“We know that clozapine has the highest efficacy of all the antipsychotics and it is now clear, after all, that it is not that risky or dangerous a treatment,” study leader Jari Tiihonen of the University of Kuopio said in a telephone interview.

“We should consider whether clozapine should be used as a first-line treatment option.”

THOUSANDS OF PREMATURE DEATHS

Tiihonen estimates clozapine is given to around one fifth of Finnish schizophrenia patients, but less than 5 percent in the United States.

Clozapine’s side effects include agranulocytosis, a potentially fatal decline in white blood cells, and current rules stipulate the drug can only be used after two unsuccessful trials with other antipsychotics.

Tiihonen and colleagues wrote in the Lancet medical journal that these restrictions should be reassessed in the light of their findings, since not using the drug may have caused thousands of premature deaths worldwide.

But Les Iversen, a professor of pharmacology at the University of Oxford in Britain, who wasn’t involved in the study, said the risk of agranulocytosis was serious and should not be under estimated.

“For this reason, clozapine has become a drug of last resort -- and will probably remain so,” he said.

Seroquel, Zyprexa and Risperdal are among the world’s top-selling drugs, with combined sales of $12.5 billion in 2008, though Risperdal now faces generic competition.

Worries about the safety profile of all the atypical antipsychotics have loomed large since 2002, however, following evidence of increased rates of diabetes and cardiovascular disease.

The Finnish study found no pronounced differences in heart deaths between the different atypicals, but patients on clozapine had a substantially lower risk of suicide, while those on Seroquel were more likely to kill themselves.

An AstraZeneca spokeswoman said the Anglo-Swedish company was comfortable that Seroquel was safe, effective and an important treatment for mental illness.

Schizophrenia is a severe psychiatric disorder in which patients experience distorted thinking, hallucinations and abnormal emotions.

Editing by Jon Loades-Carter/Will Waterman

Our Standards:The Thomson Reuters Trust Principles.

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Banned drug may have saved schizophrenics

TECHNOLOGY / 13 JULY 2009, 10:15AM /

London - Thousands of people with schizophrenia worldwide could have been saved if doctors had prescribed them the anti-psychotic drug clozapine, a new study says.

Clozapine was introduced in the 1970s, but was banned for about a decade because of a rare but potentially deadly side effect: up to 2 percent of patients lose their white blood cells while taking the drug.

It was brought back to the market in the 1980s with warnings about its use, and is sold generically as Clozaril, Leponex, Denzapine, Fazaclo, among other names.

In most developed countries, guidelines recommend clozapine only as a last resort, if patients have already tried two other drugs but still aren't better.

In a study examining the death rates of about 67,000 schizophrenic patients in Finland versus those of the general population between 1996 and 2006, Jari Tiihonen, of the University of Kuopio in Finland, and colleagues found that patients on clozapine had the lowest risk of dying, compared to other patients with schizophrenia. The study was published online Monday in the medical journal, Lancet.

James MacCabe, a consultant psychiatrist at the National Psychosis Unit at South London and Maudsley Hospital, called the research "striking and shocking." He was not linked to the study.

"There is now a case to be made for revising the guidelines to make clozapine available to a much larger proportion of patients," he said.

Tiihonen and colleagues found that even though the use of anti-psychotic medications has jumped in the last decade, people with schizophrenia in Finland still die about two decades earlier than other people.

The researchers concluded that newer drugs including quetiapine, haloperidol and risperidone increased the death risk by 41 percent, 37 percent and 34 percent respectively, when compared to older drugs. In contrast, patients on clozapine had a 26 percent lower chance of dying. The study was paid for by Finland's Ministry of Health and Welfare.

Experts said the Finnish findings could be extrapolated to most other developed countries. MacCabe suggested doctors might give their schizophrenic patients clozapine after trying one other drug, as opposed to two.

MacCabe said clozapine is particularly effective in reducing suicidal tendencies in schizophrenic patients, in whom suicides account for about 40 percent of unexpected deaths.

"We should find ways to get more people on this medicine," said Lydia Chwastiak of the department of psychiatry at Yale University, who was not connected to the research. A study at the University of Maryland found that African-American patients in particular are treated less often with clozapine.

"If this drug can help people live longer, we need to look seriously at the barriers to using it," she said.

Tiihonen said the pharmaceutical industry is partly to blame for why clozapine has often been overlooked. "Clozapine's patent expired long ago, so there's no big money to be made from marketing it," he said.

On the Net: http://www.lancet.com

- Sapa-AP

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11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study)

Prof Jari Tiihonen, MD

Correspondence information about the author Prof Jari Tiihonen

Email the author Prof Jari Tiihonen

Prof Jouko Lönnqvist, MD

Prof Kristian Wahlbeck, MD

Prof Timo Klaukka, MD

Prof Leo Niskanen, MD

Antti Tanskanen, PhLic

Jari Haukka, PhD

Published: 13 July 2009

DOI: https://doi.org/10.1016/S0140-6736(09)60742-X

Article Info

Summary

Background

The introduction of second-generation antipsychotic drugs during the 1990s is widely believed to have adversely affected mortality of patients with schizophrenia. Our aim was to establish the long-term contribution of antipsychotic drugs to mortality in such patients.

Methods

Nationwide registers in Finland were used to compare the cause-specific mortality in 66 881 patients versus the total population (5·2 million) between 1996, and 2006, and to link these data with the use of antipsychotic drugs. We measured the all-cause mortality of patients with schizophrenia in outpatient care during current and cumulative exposure to any antipsychotic drug versus no use of these drugs, and exposure to the six most frequently used antipsychotic drugs compared with perphenazine use.

Findings

Although the proportional use of second-generation antipsychotic drugs rose from 13% to 64% during follow-up, the gap in life expectancy between patients with schizophrenia and the general population did not widen between 1996 (25 years), and 2006 (22·5 years). Compared with current use of perphenazine, the highest risk for overall mortality was recorded for quetiapine (adjusted hazard ratio [HR] 1·41, 95% CI 1·09–1·82), and the lowest risk for clozapine (0·74, 0·60–0·91; p=0·0045 for the difference between clozapine vs perphenazine, and p<0 0="" all="" an="" and="" antipsychotic="" any="" associated="" between="" cumulative="" drug="" drugs="" duration="" exposure="" filled="" for="" in="" inverse="" long-term="" lower="" more="" mortality="" no="" noted="" of="" one="" or="" other="" p="" patients="" per="" prescription="" relation="" than="" to="" treatment="" trend="" use="" was="" with="" year="" years="">

Interpretation

Long-term treatment with antipsychotic drugs is associated with lower mortality compared with no antipsychotic use. Second-generation drugs are a highly heterogeneous group, and clozapine seems to be associated with a substantially lower mortality than any other antipsychotics. Restrictions on the use of clozapine should be reassessed.

Funding

Annual EVO Financing (Special government subsidies from the Ministry of Health and Welfare, Finland).

Saturday, February 10, 2018

Parsifal

Review: A Conductor Delivers a Magnificent ‘Parsifal’ at the Met

PARSIFAL

NYT Critic’s Pick

By ANTHONY TOMMASINIFEB. 6, 2018

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Kundry (Evelyn Herlitzius, on bed) and Parsifal (Klaus Florian Vogt) in Klingsor’s realm, dominated by a sea of blood, in “Parsifal” at the Metropolitan Opera. CreditRichard Termine for The New York Times
On Monday, Yannick Nézet-Séguin, the Metropolitan Opera’s music director designate, conducted a magnificent performance of Wagner’s “Parsifal.” This demonstration of his artistry and his ability to inspire the best from the company’s orchestra and chorus was a good sign of things to come.

It was also frustrating. Not until 2020, three seasons from now, will Mr. Nézet-Séguin become the music director full time. This seven-performance run of “Parsifal,” which ends on Feb. 27, and six performances of Strauss’s “Elektra” next month are his only engagements this season.

This teaser comes just as the company is in dire need of musical leadership. James Levine had already been mostly sidelined when he was suspended as music director emeritus in December over allegations of sexual harassment. The Met official in charge of artistic administration, Robert Rattray, died suddenly a little over a week ago.

Are all artistic matters now entirely in the hands of the general manager, Peter Gelb? This has long been the way Mr. Gelb conceived his role. But even regarding musical matters, how much input can Mr. Nézet-Séguin, whose substantial workload includes the directorship of the Philadelphia Orchestra, be having?

Photo

Peter Mattei, far left, as the wounded Amfortas in “Parsifal.” CreditRichard Termine for The New York Times
These questions hovered over Monday’s revival of François Girard’s bleakly poignant 2013 production, even as Mr. Nézet-Séguin brought his own strong take to this profound, challenging and very long score. (With two lengthy intermissions, the performance lasted nearly six hours.)

During the first sighing unison phrase of the prelude, the strings played with hushed yet penetrating tone, rising with a touch of hesitation and slowly swelling in sound and radiance, until the upper strings crested into delicate, lacy arpeggios. Mr. Nézet-Séguin took a daringly restrained tempo here. The prelude — and whole episodes of the opera proper — invite the listener into a spiritual realm where, as one character puts it, “time becomes space.” Mr. Nézet-Séguin conveyed that beautifully.
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Yet when called for, he also brought out the urgency and incisiveness of the music. At the opening of Act II, set in the bewitched castle of the sorcerer Klingsor, Mr. Nézet-Séguin tore into the heaving music with searing fervor. I’ve never heard the passage sound so fraught and dangerous.

The tenor Jonas Kaufmann sang the title role when this production was new and set a high standard. Klaus Florian Vogt may have a lighter voice and lacks Mr. Kaufmann’s charisma. But on this night he was deeply affecting as Wagner’s clueless youth, who chances upon the sanctuary of the desolate knights of the Holy Grail and is baffled by their sacred rituals. (He sang the role to acclaim in a new production at the Bayreuth Wagner Festival in Germany in 2016.)

Mr. Vogt’s voice has youthful brightness. In climactic moments, his focused sound penetrated the orchestra with vigor. But while the knights await a “pure fool” who, it has been prophesied, will bring renewal to the brotherhood, sometimes Mr. Vogt played the fool a little too well. He seemed a little lost.

Photo

René Pape, center, as Gurnemanz, a veteran of the brotherhood of knights of the Holy Grail in “Parsifal.”CreditRichard Termine for The New York Times
The bass René Pape may not have all the stentorian power he once did. But with his deep, dark and imposing voice, he again proved ideal as Gurnemanz, a veteran knight. And the way he links crisp enunciation of the words to vocal sounds and colorings remains a model for singers.

The baritone Peter Mattei was extraordinary as Amfortas, the suffering king of the grail knights, when this production was new, and was perhaps even more so on Monday. Amfortas suffers from a wound that will not heal, inflicted when he was lured into Klingsor’s realm; seduced by the mysterious, ageless Kundry; and stabbed with a sacred spear he had been entrusted to protect. Mr. Mattei brings such desperate fervor to his singing that you can believe in this Amfortas’s vulnerability. The character’s suffering and guilt were apparent in the anguished tone of Mr. Mattei’s singing and the wracked movements of body.

The slightly hard-edge sound of the soprano Evelyn Herlitzius, making her Met debut as Kundry, takes some getting used to. Her voice can wobble on sustained tones. But there was earthy intensity, even a kind of beautiful fragility, to her singing. And dramatically she drew out every elusive nuance of this confounding character.

Mr. Girard’s production retains its gloomy power. The costumes are modern: The knights wear white shirts and charcoal pants and go barefoot. Their “forest” has a post-apocalyptic bleakness. In a theatrical tour de force, the female demons who, at the command of Klingsor (the menacing bass-baritone Evgeny Nikitin), become the flower maidens who try to seduce Parsifal in Act II, slosh around in a shallow pool of blood that drips from the walls and covers the stage. There are no traces of the meadows, or the woodland murmurs the libretto refers to. But the production counts as a high point of Mr. Gelb’s tenure to date.

Still, who is advising him on musical (and larger artistic) priorities? Mr. Nézet-Séguin’s full arrival, which this performance made me anticipate even more excitedly, seems a long way off.

REVIEW

Wagner’s ‘Parsifal’ Returns to Save the World—Maybe Even the Met

By James Jorden • 02/06/18 11:05am

Parsifal (Klaus Florian Vogt) returns to the Grail Kingdom to heal the ailing Amfortas (Pater Mattei). Ken Howard / Met Opera

Call in sick at work. Hire a sitter for your kids, dogs or significant other. Take a long nap, then slam back a triple espresso. That may sound like a daunting prep for an evening at the opera, but the Met’s stunning revival of Richard Wagner’s Parsifal is more than just highbrow entertainment. It’s an artistic experience that could change your life.

That’s just what the composer intended this 1882 epic to accomplish. From a swath of medieval source material about a naïve young boy’s path to the exalted rank of guardian of the Holy Grail, he devised a massive drama that not only relates an archetypal hero myth but proposes a new belief system for Western society, fusing Catholicism, Buddhism, Schopenhauerian philosophy, animal rights and Earth religion.

But you don’t have to convert to be overwhelmed by this Parsifal, especially as visualized in the Met’s pensive, immaculately edited production by François Girard. He transposes the action from the Middle Ages to an eerie dystopian near future, conjuring a fundamentalist, sex-negative social order not unlike that in The Handmaid’s Tale.

Girard’s vision was terrifying enough five years ago when the production premiered, but now its depiction of the total breakdown of relationships between the sexes feels almost torn from the headlines. Parsifal’s mission becomes something much more real and necessary than the rescue of a magical spear: he has to reunite a society splintered into mindless male cults and soulless female militias.

Several of the singers in this season’s cast are veterans of the Met’s 2013 incarnation of the work, and, excellent as they were then, they have all gained depth and subtlety in the time since.

Most impressive in his development is the bass René Pape, whose long role of Gurnemanz consists largely of filling in the opera’s complex back story. If his luxurious bass now reveals an occasional trace of scratch, that only add a patina to its beauty. More to the point, his declamation never feels oratorial or formal; every word and every inflection is so natural and intimate the whole performance feels like it’s overheard.

As the malevolent Klingsor, Evgeny Nikitin filed his elegant bass-baritone down to an animalistic snarl. The character of the sorcerer was all the more terrifying for his lack of self-awareness: he was not merely evil but possessed by a demon.

Surely the centerpiece of this performance, though, is Peter Mattei as the tormented Grail King Amfortas. It is this character’s moral failing (and his subsequent tortured and unending remorse) that drives this story, and, strangely enough, the sheer sensual beauty of Mattei’s baritone made the tragedy almost unbearably touching. Even his wildest screams of pain never turned ugly, communicating the insight that even the most abased of creatures is still human, still cherishable.

Mattei’s performance, one of the strongest I’ve ever seen in the theater, at first cast a bit of a shadow over the two new additions to the cast, but they hold their own. Soprano Evelyn Herlitzius fascinated as the enigmatic shape-shifter Kundry, her “dialed up to 11” acting delineating the character’s curse of experiencing eternal life as a series of devious performances. Her muscular voice admittedly has quite a few miles on it, but her sterling commitment made even a few yelps standing in for high notes sound organic.

It is altogether fitting that in so ambiguous a work as Parsifal, the title role should be performed the paradox that is Klaus Florian Vogt. You would think this hulking blond giant would emit a mighty roar, but instead what emerges is a light, heady tenor only slightly darker than a boy soprano’s piping.

Vogt is thus simultaneously a child and a man, a sort of time-lapse photograph of the hero’s journey. Though in affect he is the polar opposite of Jonas Kaufmann’s glamorously moody hero as heard in 2013. Vogt is, if anything, more effective in the part, more intensely concentrated and, I thought, more cognizant of the awesome responsibility the character assumes.

And yet the most moving epiphany of the night was the conducting of the Met’s new music director Yannick Nézet-Séguin, sweetly poetic and, even in the score’s direst moments, glowing with hope. As in last season’s Fliegende Holländer, Nézet-Séguin lent the music an irresistible forward motion, never rushed, but rather with the verve of a great raconteur relating the most fascinating story in the world. When he took his bow, the great roar of bravos from the Met audience felt like…well, an anointing.

The Met has taken some hard knocks in recent months and years, and yet, after last night’s Parsifal, you can’t help feeling hopeful. The company looks like it’s going to survive, and Yannick Nézet-Séguin is going to be its savior.

Metropolitan Opera 2017-18 Review – Parsifal: A Brilliant Cast Shines In Met’s Greatest Production Of Last Decade

TOPICS:Evelyn Herlitzius Evgeny Nikitin Klaus Florian Vogt Metropolitan Opera Parsifal Peter Mattei Rene Pape Wagner

(Credit: Metropolitan Opera)

POSTED BY: DAVID SALAZAR FEBRUARY 6, 2018

The world is divided into men and women. And only the unification of these two sides, through mutual understanding and respect can bridge the gap and bring about a new world full of equality.

Sounds familiar right? It was what François Girard saw prior to 2013, and his vision remains ever true to this day. Perhaps even more prevalent.

It is this kind of vision and understanding of human nature that makes his “Parsifal” arguably the single greatest production to arrive at the Metropolitan Opera in the last 20 or so years. No joke.

And for the second straight time since the production opened in 2013, the company has put together a superstar cast that adds to the genius of the mis-en-scene.

Let’s dig in.

Prescient Vision

The lights go out and we are greeted with a curtain showcasing the Met auditorium, almost as if a mirror were being held up to the audience. Then the curtain rises and a sea of people, clad in black appear facing the audience. Among them is Parsifal. The group features both men and women, though they seem to be moving in different directions; only Parsifal looks lost as to where to go. The men remove their black clothing and ties, revealing white undergarments, emphasizing themselves as pure knights of the grail. Then they move stage left and form a circular configuration of chairs; the woman go in the opposite direction to a side separated by a fissure in the ground. This division dominates the work and portrays a divisive civilization, one in which men and women are at odds with one another. Given the current nature of our society, this opera could not be more revelant in this interpretation.

Throughout Act one, we get the ritual of the grail showcased amidst video a planet, clouds, deep space, and even hints of a human body that on closer inspection can look like the bread that Christ associates with his flesh. Or is it the sin of the world that is constantly mentioned in the opera? The voice of Titurel booms throughout the theater almost suggesting God. This portrayal takes on more prevalent meaning when Gurnemanz states in Act three that Titurel died “like any other man;” the subversion of God in a modern society.

The opera’s theme of male-female divison is embedded in its very structure. While Act one clearly belongs to the men, the second act is dominated by women and the final one, at least in this version, showcases a reconciliation. The second act sees the manipulation of the women from the opening act, which Girard has previously noted as “aspects” of Kundry, by the villainous Klingsor. He has them do his bidding, and its pretty sexual in nature. No doubt watching the man toss blood around from the inside of a female genitalia (that is where Act two takes place, right?) is rather uneasy to watch in the current social mileu. That Parsifal comes in and liberates everyone might strike some as wrong for a number of reasons, but Girard isn’t trying to destroy the opera’s text either. But he ultimately does make a brilliant move in the final act to lend it social relevance and acceptance.

Act three reverts to the opening set, but with the world in abrupt turmoil. Time has passed and the knights have disbanded, forced to eat whatever they can find. A burial is taking place and the rules and divisions established in the opening act are completely eroded. Only Kundry, the symbol of “sin” in the world, is unable to cross the gap.

Then Parsifal arrives in an incredible theatrical coup, his silhouette generating a sense of mystery. As he draws nearer, he comes into the light and becomes clearer. The man who was a mystery is now the redeemer of all. From there the work moves into pure sublime beauty, Gurnemanz and Kundry washing the feet and brow of the weary Parsifal as he is hailed King and leader of the knights. Then Parsifal proceeds to help Kundry cross the chasm and be absolved of sin.

And to clinch it all, Kundry is the one to open the grail, a move often left to the men. While she dies, her evolution throughout the production explores women being allowed to return to their rightful place – as equals of men. In the final image of the night, as Parsifal lifts up the chalice, the stage is littered with men and woman together. They wear similar clothing and the gap in the ground is barely recognizable. A new society begins with the inequality done away with.

But Girard isn’t even finished there because in the very final moment of the piece, with Parsifal lifting the chalice, two figures stand amidst the kneeled crowd. One is Amfortas, the former King whose sin caused the turmoil of the brotherhood. The other is a woman clad in black. There are a few people still porting the black, but most are clad in white. The woman stands out amidst this crowd. And with the curtain dropping, Parsifal turns and glances in her direction. It leaves the viewer with a lot of questions. Is this a new Kundry and is Parsifal to follow Amfortas’ path, resetting the cycle back? Or is this the sign of progress? Of a woman set to come and rule alongside Parsifal? It is a brilliant touch that avoids leaving this seemingly positive outlook filled with a tinge of ambiguity. Life isn’t so simple, afterall.

One final note – after seeing blood flow throughout the chasm in the opening act, the final imagery showcases water. Human’s open wound has been closed and the sacred fountain restored.

Return of the Titans

The cast is absolutely sensational in every respect. Four years ago, Peter Mattei and René Pape reigned supreme as Amfortas and Gurnemanz respectively.

On Monday, they were even better.

Mattei was an absolute scene stealer every single time he was onstage, his voice ringing out imperiously into the cavernous Met. It’s almost impossible to believe that he didn’t have a microphone, so gargantuan was the ring throughout the theater. It was heartbreaking to hear this glorious sound usher out one pained phrase after another and yet Mattei always sustained incredible sense of technical precision. He built up his monologue so beautifully, each phrase more tortured than the previous one that his cries of “Erbarmen! Erbarmen!” were sublime climaxes to it all. He had even greater desperation, but also a more tragic sense of loss in the third act, jumping into the tomb in the ground, his movements more erratic at times and yet his voice softer and more muted. But the moments where he is called upon to blast out in increased pain showed him even more potent and forceful vocally.

The same could be said for Pape, who was clarity embodied as Gurnemanz. The character’s main role is as the narrator of the opera and the emotional range is limited at best in the opening act. However, his gentle nature came through in the final act in his interactions with Parsifal, his gloriously rich bass sound at its finest. His physicality was also rather telling, Pape imbuing the character with a signature pacing movement throughout the opening act, only to show that same movement impaired and weaker in the final third of the opera. It added to the sense of Gurnemanz being somehow broken over the failures of the knights.

Evgeny Nikitin returned to the role of Klingsor and relished it. His voice was pointed, vicious and his movements were in direct contrast with everyone else onstage. He had no qualms about moving with snakelike precision. His scene with Evelyn Herlitzius’ Kundry is simply exquisite in how the two voices blasted sound at one another in visceral confrontation.

Ever Thrilling & Fascinating

Speaking of Herlitzius, the German soprano was making her North American and Metropolitan Opera debut. Her voice isn’t a pretty sound whatsoever. One could even define it as abrasive, with a sharp vibrato that wobbles a bit in the upper range. But one could never accuse her of being boring or uninteresting. In fact, she is the complete opposite. Her Kundry was completely unhinged from the start, her exaggerated laughs and moans always off-putting for the viewer, but adding to the interest. You always wanted to know what she was going for and where she was going with the character. And she showed some tremendous range. She was overpowered in her fight with Klingsor, even if vocally she gave it her all and put up quite the fight. In her seduction of Parsifal, she was alluring and sensual. But when rejected, she was the embodiment of “hell hath no fury as a woman scorned,” her singing blistering in its power and strength. It was endlessly thrilling to see her rise into the soprano stratosphere, even if it wasn’t always pretty.

Victory Through Compassion, Not Power

Speaking of pretty, let’s talk about Klaus Florian Vogt, whose interpretation was simply beautiful. To some his voice seems out of place in a Wagner opera. I’ve even heard of him as being a “pushed-up Tamino.” It might all be completely right and at the same time it doesn’t matter. When writing his operas, Wagner called for bel canto style singing in the vein of his beloved Bellini. We don’t usually get that from tenors, mainly because the heavy and thick voices we are accustomed to can’t quite carry lines in that manner or with that “bel canto” beauty. But Vogt’s does. Moreover, his voice carries tremendous weight that cuts through the orchestra quite splendidly. His “Amfortas! Die Wunde!” was a perfect example of this, the delicate timbre suddenly thick and potent. But the true beauty of a passage such as this one was the sense of expansion of the line, giving the passage true anguish and introspection. And because of the complexion of his voice, Vogt could add nuance and layers to his Parsifal as a true “innocent fool.” Whereas other heroic tenors can’t genuinely sound like an innocent or pure man, Vogt can and he used it to his full advantage. One such example was the climactic showdown with Klingsor where with his hand raised he stops the wizard in his tracks and utters, “Mit diesem Zeichen bann’ich deinen Zauber.” He could have taken the approach of belting out this power declaration of victory, but instead opted for gentleness. At the end of the opera, Parsifal wins and unites the world through compassion, not strength. And in his greatest moment of victory over evil, he wins not through brute force, but through this very same emotion. The choice by Vogt is potent and insightful all the same. He brings a similar vocal quality in his final scene, furthering the point of Parsifal’s victory coming through compassion and love and not the violence and might of such Wagnerian heroes as Siegfried or Tristan (ironically, these heroes ultimately find death after said victories).

Musical Introspection

It is often said that, in Schopenhauerian terms, Wagner’s music could be described as “the will” personified. But in “Parsifal,” one might be more inclined to say that the majority of the music is the “abnegation” of said will. Instead of incessant brooding and propulsive momentum, Wagner’s last score is gentle, subdued, and even ponderous. It doesn’t move anywhere all that quickly (except for Act two), more interested in living in the moment, as Gurnemanz notes, where time becomes space. And it seems that maestro Yannick Nézet-Séguin approaches the score with this gentle nature in mind. His tempi tend to be broad, particularly when Wagner calls for lengthy pauses. You could feel the spacing throughout the prelude, the silences introspective and invitations to dig deeper. But what made his interpretation truly unique was the overall restraint you could feel. The entrance of the knights to close out the opening act did not emphasize the march-like nature that is often given grandiosity in other interpretations. Here it remained subdued, the transition more focused on the shift in mood. That isn’t to say that he wasn’t aggressive or didn’t push the Met Orchestra to its full voluminous potential. The music frayed and blistered powerfully throughout the second act as the tensions grew. But it all came back to the level of sublime tenderness in the final act, the final phrases simply divine.

There were a few orchestral misfires to be honest, with the brass section audibly uncomfortable and out of sync on some cues, but this is likely to improve with each passing performance.

So yes, this night was truly mesmerizing and for the second time in as many tries the Metropolitan Opera has a true winner with François Girard’s “Parsifal.” It is undeniably the finest Wagner production at the Met right now and the hope is that the director will come back and direct another production at such a high level. It also helps to have such an incredible cast in the ranks.

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