Efficacy of clozapine for long‐stay patients with treatment‐resistant schizophrenia: 4‐year observational study

Abstract

Aim: Supporting patients upon discharge following prolonged hospitalization in private psychiatric hospitals in Japan have long been an issue. This study evaluated the efficacy of clozapine in treating long-stay patients with treatment-resistant schizophrenia to reduce the frequency and duration of readmissions postdischarge. Methods:We retrospectively examined the length and frequency of hospitalizations of long-stay and non-long-stay patients with schizophrenia who were introduced to clozapine at our hospital.Results: Comparing participants' medical records 2 years before and after the introduction of clozapine, we identified a significant decrease in both length and frequency of hospitalizations in all patients who were introduced to clozapine. In long-stay patients, the length and frequency of hospitalization were significantly reduced.However, compared to non-long-stay patients, the period from introduction of clozapine to discharge was longer and the dose of clozapine was higher. Thus, it is necessary to take time to evaluate the therapeutic effects for long-stay patients. Conclusion:The results showed that clozapine is helpful for patients with treatmentresistant schizophrenia, who are considered difficult to treat and discharge in Japan.

Rational and Translational Implications of D-Amino Acids for Treatment-Resistant Schizophrenia: From Neurobiology to the Clinics

“…Treatment-resistant schizophrenia (TRS) patients have more severe abnormal functioning [4], cognitive deficits [5,6], and neurological soft signs [7]. The only antipsychotic available for TRS therapy is clozapine [2,[8][9][10], a highly efficacious drug whose utilization in clinical practice is undermined by relatively rare but severe adverse events such as agranulocytosis, myocarditis, intestinal hypomotility, and convulsions [11]. Therefore, clozapine is largely underused and frequently introduced very late, when the trajectory of the disease is already advanced [12].…”