Treatment of Clozapine Nonresponders

Grover, Sandeep

doi:10.1007/s40501-019-0166-4

Cited by 5 publications

(1 citation statement)

References 154 publications

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“…Accordingly a significant number of studies and reviews have focused on augmentation of clozapine. 17 Third, considering the fact that patients with TRS are a specific subgroup of schizophrenia, researchers have tried to evaluate the neurobiological underpinning of TRS and also the factors which predict the response or non-response to clozapine. 18 This has led to sustained research attention on clozapine.…”

Section: Diagnostic Groups and Clozapinementioning

confidence: 99%

Clozapine: A Scientific Analysis of Global Publications during 1970-2021

Grover¹,

Gupta

Ahmed³

et al. 2022

Int J. Pharm. Investigation

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in 1989, after it was approved by the United States Food and Drug Administration. In this initial trial Kane et al., 3 showed that clozapine was significantly more effective than chlorpromazine in patients who failed to respond to multiple adequate trials of different antipsychotics. 3 After this trial, use of Clozapine increased and its use was limited to patients with TRS. Over the years, the definition of TRS has been revised by different researchers, authors and organization. 4 Although these attempts have been towards increasing clozapine use in clinical practice, it is still considered to be underutilized. Available data suggests that starting of clozapine is often delayed by 1.5 to 2 years. 5 Over the years many reviews and meta-analysis have evaluated the effectiveness and side effect data for clozapine. [6][7][8][9][10][11][12] However, these publications do not provide information about the publication trends on clozapine. Bibliometrics can provide important information about the publication trends, authors involved in the research, country of origin of the authors ABSTRACT Aim: This study evaluates the research output on Clozapine included in Scopus database during 1970-2021. Materials and Methods: The quantitative and qualitative analysis of publications on "Clozapine" covered in Scopus database during 1970-2021 was undertaken. The results obtained were further analysed using additional features in Scopus database. Results: 7399 publications on "Clozapine" were obtained from Scopus international database and these publications received 189068 citations, averaging 25.55 citations per paper (CPP). There was initial rise in the number of publications per year from 1988 to 1995, after that the number of publications has remained relatively stable. Authors from USA, U.K. and Germany contributed to the largest number of publications (2136, 709 and 457 publications respectively), and publications with authors from USA, Canada and Germany registered the highest CPP and relative citation index (RCI).

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Section: Diagnostic Groups and Clozapinementioning

confidence: 99%

Clozapine: A Scientific Analysis of Global Publications during 1970-2021

Grover¹,

Gupta

Ahmed³

et al. 2022

Int J. Pharm. Investigation

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Clozapine research from India: A systematic review

Grover

Kathiravan

2023

Asian Journal of Psychiatry

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Augmentation strategies for clozapine resistance: a systematic review and meta-analysis

Grover

Sarkar

2022

Acta Neuropsychiatr.

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Background: Several augmentation strategies have been used to improve symptomatology in patients not adequately responding to clozapine. Several randomized controlled trials (RCTs) have evaluated the efficacy of different strategies to augment clozapine. This systematic review and meta-analysis reviewed the available RCTs that have evaluated the clinical efficacy of various pharmacological agents, non-pharmacological strategies (occupational therapy, cognitive behavior therapy), and somatic treatment (electroconvulsive therapy (ECT), and repetitive transcranial magnetic stimulation etc.) as augmenting agents to clozapine. Methods: Data were extracted using standard procedures, and risk of bias was evaluated. Effect sizes were computed for the individual studies. Results: 45 clinical trials were evaluated. The pooled effect size for various antipsychotic medications was 0.103 (95% CI- 0.288 to 0.493, p <0.001); when the effect size was evaluated for specific antipsychotics for which more than one trial was available, the effect size for risperidone was -0.27 and that for aripiprazole was 0.57. The effect size for lamotrigine was 0.145, and that for topiramate was 0.392. The effect size for ECT was 0.743 (CI: 0.094 -1.392). Risk of bias was low (mean Jadad score- 3.93). Largest effect sizes were seen for mirtazapine (effect size of 5.265). Most of the studies can be considered underpowered and limited by small sample sizes. Conclusions: To conclude, based on the findings of the present systematic review and meta-analysis, it can be said that compared to other treatment strategies, clozapine non-responsive patients respond maximum to mirtazapine followed by ECT.

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Treatment of Clozapine Nonresponders

Cited by 5 publications

References 154 publications

Clozapine: A Scientific Analysis of Global Publications during 1970-2021

Clozapine: A Scientific Analysis of Global Publications during 1970-2021

Clozapine research from India: A systematic review

Augmentation strategies for clozapine resistance: a systematic review and meta-analysis

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