Author:
Howes Oliver D.,Vergunst Francis,Gee Siobhan,McGuire Philip,Kapur Shitij,Taylor David
Abstract
BackgroundClozapine is the only antipsychotic drug licensed for treatment-resistant schizophrenia but its use is often delayed. Since previous studies, national guidelines on the use of clozapine and other antipsychotics have been disseminated to clinicians.AimsTo determine the theoretical delay to clozapine initiation and to quantify the prior use of antipsychotic polypharmacy and high-dose antipsychotic treatment.MethodClinico-demographic data were extracted from the treatment records of all patients commencing clozapine in our centre between 2006 and 2010.ResultsComplete records were available for 149 patients. The mean theoretical delay in initiating clozapine was 47.7 months (s.d. = 49.7). Before commencing clozapine, antipsychotic polypharmacy and high-dose treatment was evident in 36.2 and 34.2% of patients respectively. Theoretical delay was related to illness duration (β = 0.7, P<0.001) but did not differ by gender or ethnicity.ConclusionsSubstantial delays to clozapine initiation remain and antipsychotic polypharmacy and high doses are commonly used prior to clozapine, despite treatment guidelines.
Publisher
Royal College of Psychiatrists
Subject
Psychiatry and Mental health
Cited by
271 articles.
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