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The Impact of Clozapine Delay on Clinical Outcomes in Schizophrenia

Claire Law, Yuen Mei See, Jie Yin Yee, Boon Tat Ng, Charmaine Tang Yu Zheng, Jimmy Lee

2023The Journal of Clinical Psychiatry11 citationsDOI

Abstract

Clozapine is the drug of choice indicated for treatment-resistant schizophrenia (TRS), but delays in initiation and underutilization might have affected its effectiveness in practice. In this study, we sought to examine the clinical outcomes of patients on clozapine treatment and if a delay in initiation was associated with poorer outcomes. (SCID-I) to ascertain diagnoses of schizophrenia and schizoaffective disorder. Each patient was assessed on the Positive and Negative Syndrome Scale (PANSS) and Social Occupational Functioning Assessment Scale (SOFAS). Past antipsychotic treatment trials were obtained from the medical records. Symptom remission status was defined using the PANSS symptom criteria proposed by Andreasen and colleagues in 2005. Functional remission was defined as a SOFAS score ≥ 60. = .011) groups. Our study found a significant delay in the initiation of clozapine despite current guidelines indicating it for TRS. This delay might have contributed to the poorer clinical outcomes. Further research is needed to provide a clearer understanding of clozapine delay, evaluate its impact on outcomes, and find ways to improve access to clozapine.

Topics & Concepts

Schizoaffective disorderClozapineSchizophrenia (object-oriented programming)Positive and Negative Syndrome ScaleMedicineAntipsychoticInterquartile rangePsychiatryInternal medicinePsychosisPsychologySchizophrenia research and treatmentMental Health and PsychiatryOccupational Therapy Practice and Research
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