Real-World Antipsychotic Treatment Practices

Moore, Troy; Covell, Nancy H.; Essock, Susan M.; Miller, Alexander L.

doi:10.1016/j.psc.2007.04.008

Cited by 35 publications

(29 citation statements)

References 79 publications

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“…Treatment-resistant schizophrenia has been established to affect 20-30% of all patients diagnosed with schizophrenia [21,31]. Nevertheless, physicians' prescribing practices reveal that only a small portion of patients with treatmentresistant schizophrenia are treated with clozapine [21].…”

Section: Clozapine Prescribing Trendsmentioning

confidence: 99%

Section: Clozapine Prescribing Trendsmentioning

confidence: 99%

“…Nevertheless, physicians' prescribing practices reveal that only a small portion of patients with treatmentresistant schizophrenia are treated with clozapine [21]. In 1999, only 160,000 US patients of the 2.6 million diagnosed with schizophrenia were treated with clozapine (only 25% of treatment-resistant patients) [21]. Since the introduction of the newer SGAs, clozapine use decreased in the United States: in 1999, clozapine represented 11% out of the total SGAs prescribed, which steadily decreased to less than 5% in 2002 [21].…”

Section: Clozapine Prescribing Trendsmentioning

confidence: 99%

“…During phase 3 of the CATIE study, 51% of patients had previously discontinued medications due to ineffective therapeutic response, but only 11% of patients were offered clozapine during phase 3. Studies of clozapine utilization have shown that adherence to guidelines has been poor through the years with clozapine been consistently underutilized in the US, UK, Canada, New Zealand and Australia [9,[21][22][23][24][25][26][42][43][44][45][46]. In a study of the Veterans Health Administration, only 2% of patients affected by schizophrenia were receiving clozapine [22].…”

Section: Clozapine Prescribing Trendsmentioning

confidence: 99%

“…However, none of the newer SGAs could demonstrate superiority to clozapine and in the last decade many published clinical practice guidelines [13][14][15][16][17][18][19][20] have recommended that clozapine be prescribed to patients with treatment-resistant schizophrenia, which has been defined as not responsive to two trials of any other antipsychotic medication (either FGA or SGA). Despite such recommendations and the overwhelming evidence of clozapine effectiveness, prescribing of clozapine appears to be low, delayed and often preceded by attempts at polypharmacy treatment, which lacks clinical evidence of effectiveness [21][22][23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

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A Case of Drug-Induced Acute Dyskinesia Treated with Korean Medicine

Lee¹,

Shin²,

Kim³

et al. 2017

J Int Korean Med

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Background: Clozapine effectiveness in the treatment of refractory schizophrenia has been sustained by published evidence in the last two decades, despite the introduction of safer options. Discussion: Current clinical practice guidelines have strongly recommended the use of clozapine in treatment-resistant schizophrenia, but prescribing trends do not appear to have followed such recommendations. Clozapine is still underutilized especially in patients at risk of suicide. It seems that physicians are hesitant in prescribing clozapine due to concerns about serious adverse effects. Recent reports have highlighted the need to inform health professionals about the benefits of treating patients with clozapine and have voiced concerns about the underutilization of clozapine especially in patients at risk of suicide. Summary: Guidelines and prescribing patterns reported in various countries worldwide are discussed. Suggestions on how to optimize clozapine utilization have been published but more efforts are needed to properly inform and support prescribers' practices.

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Section: Clozapine Prescribing Trendsmentioning

confidence: 99%

Section: Clozapine Prescribing Trendsmentioning

confidence: 99%

Section: Clozapine Prescribing Trendsmentioning

confidence: 99%

Section: Clozapine Prescribing Trendsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A Case of Drug-Induced Acute Dyskinesia Treated with Korean Medicine

Lee¹,

Shin²,

Kim³

et al. 2017

J Int Korean Med

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Clozapine prescribing practice and trends in Qatar: First national observational study

et al. 2022

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Background: Clozapine is the gold standard in the management of treatment-resistant schizophrenia. Despite its clinically proven efficacy clozapine utilization is variable globally and published evidence is suggestive of its underutilization. Research from the Arab region on clozapine utilization is limited. The aim of our descriptive observational study was to evaluate the prescribing practice of clozapine and its sociodemographic and clinical corelates in the State of Qatar. Methods:The study is a retrospective case-note review of all patients maintained on clozapine, in the calendar year 2020. Data were collected on sociodemographic characteristics of the patients; antipsychotic trials before initiating clozapine; and clinical characteristics of the patients, including their diagnoses leading to prescription of clozapine, duration of illness, psychiatric hospitalizations, and co-morbidities.Results: During the study period, 100 patients were maintained on clozapine. Patients were mostly Qatari and non-Qatari Arab males. Prescription rates were significantly different for Qatari patients when compared to non-Qatari patients. Most patients had a chronic illness with the age of onset of illness in early adulthood and were diagnosed with schizophrenia or schizoaffective disorder. The mean daily dose of clozapine was 325 mg. Eighty percent of the patients received two or more antipsychotic trials before initiating clozapine. Sixty-eight percent of the patients had more than two antipsychotic trials before initiating Clozapine. One third of patients had no history of psychiatric hospitalizations, and one quarter had five or more previous psychiatric hospitalizations. Of the psychiatric comorbidities, mood and substance use disorders were common. Of medical comorbidities, endocrine and metabolic disorders were common. Conclusion: Despite apparent underutilization, the Clozapine prescribing rates inQatar are comparable to countries with plasma monitoring systems when framed within Qatar's unique demographic context. However, there still is a significant delay in Clozapine initiation despite its clinical superiority.

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Poor Adherence to Antipsychotic Medication in People with Schizophrenia: Diffusion, Consequences and Contributing Factors

Sacchetti¹,

Vita²

2013

Adherence to Antipsychotics in Schizophrenia

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Real-World Antipsychotic Treatment Practices

Cited by 35 publications

References 79 publications

A Case of Drug-Induced Acute Dyskinesia Treated with Korean Medicine

A Case of Drug-Induced Acute Dyskinesia Treated with Korean Medicine

Clozapine prescribing practice and trends in Qatar: First national observational study

Poor Adherence to Antipsychotic Medication in People with Schizophrenia: Diffusion, Consequences and Contributing Factors

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