Patients with treatment-resistant schizophrenia are more likely to have better outcomes if they are switched to clozapine vs. another standard antipsychotic, results from a new study published in the American Journal of Psychiatry has shown. 

Up to 30% of patients do not respond adequately to standard treatments and are considered to have treatment-resistant schizophrenia. Clozapine has demonstrated to be effective for these cases but its efficacy in clinical practice has not been fully studied. 

RELATED: Major Prescribing Changes for Clozapine

Researchers from Columbia University Medical Center conducted a study (n=6,246) using 2001–2009 data from Medicaid patients whose treatment patterns exhibited resistance to compare the efficacy of clozapine vs. standard antipsychotics in routine practice settings. The primary outcome was hospital admission for a mental disorder. 

Initiation of clozapine was associated with significantly fewer hospitalizations (HR 0.78, 95% CI: 0.69–0.88), patients stayed on the new medication longer (HR 0.60, 95% CI: 0.55–0.65), and were less likely to need to use additional antipsychotics(HR 0.76, 95% CI: 0.70–0.82). , 

Recently, the Food and Drug Administration (FDA) expanded access to clozapine by allowing prescribers to make decisions based on the individual’s benefits and risks instead of following universal standards, although regular blood monitoring is still required. from the study “give clinicians important guidance for how to help an extremely vulnerable group of people,” said Dr. T. Scott Stroup, MD, lead author of the study.

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