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Clozapine: Is Now the Time for More Clinicians to Adopt This Orphan?

Published online by Cambridge University Press:  21 August 2014

Stephen M. Stahl
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Abstract

ISSUE:Although many patients with schizophrenia fail to respond adequately to trials of 2 or more antipsychotics, utilization of clozapine for these patients remains low, despite recommendations for its use by accepted treatment guidelines. Some experts estimate that 5–10 times more patients could benefit from clozapine than who are now receiving it. Learning how to manage the unique side effect profile of clozapine can potentially remove barriers to prescribing this agent and thus unlock its unique therapeutic efficacy for more patients.

Type
Brainstorms
Information
CNS Spectrums , Volume 19 , Issue 4 , August 2014 , pp. 279 - 281
Copyright
Copyright © Cambridge University Press 2014 

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References

1.McEvoy, JP, Lieberman, JA, Stroup, TS, etal. Effectiveness of clozapine versus olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia who did not respond to prior atypical antipsychotic treatment. Am J Psychiatry. 2006; 163(4): 600–610.Google Scholar
2.Hermes, E, Rosenheck, R. Choice of randomization to clozapine versus other second generation antipsychotics in the CATIE schizophrenia trial. J Psychopharmacol. 2012; 26(9): 1194–1200.Google Scholar
3.Nielsen, J, Dahm, M, Lublin, H, Taylor, D. Psychiatrists’ attitude towards and knowledge of clozapine treatment. J Psychopharmacol. 2010; 24(7): 965–971.CrossRefGoogle ScholarPubMed
4.Meltzer, HY. Clozapine: balancing safety with superior antipsychotic efficacy. Clin Schizophr Relat Psychoses. 2012; 6(3): 134–144.CrossRefGoogle ScholarPubMed
5.Stahl, SM. Stahl's Essential Psychopharmacology, 4th ed. Cambridge, UK: Cambridge University Press; 2013.Google Scholar
6.Stahl, SM, Morrissette, DA, Citrome, L, etal. “Meta-guidelines” for the management of patients with schizophrenia. CNS Spectr. 2013; 18(3): 150–162.CrossRefGoogle ScholarPubMed
7.Meltzer, HY, Alphs, L, Green, AI, etal. Clozapine treatment for suicidality in schizophrenia. Arch Gen Psychiatry. 2003; 60(1): 82–91.Google Scholar
8.Stahl, SM. The Prescriber's Guide: Stahl's Essential Psychopharmacology, 5th ed.Cambridge, UK: Cambridge University Press; 2014.Google Scholar
9.Fazel, S, Zetterqvist, J, Larsson, H, Långstrom, N, Lichtenstein, P. Antipsychotics, mood stabilisers, and risk of violent crime. Lancet. In press. DOI: 10.1016/S0140-6736(14)60379-2.Google Scholar
10.Frogley, C, Taylor, D, Dickens, G, Picchioni, M. A systematic review of the evidence of clozapine's anti-aggressive effects. Int J Neuropsychopharmacol. 2012; 15(9): 1351–1371.Google Scholar
11.Krakowski, MK, Czobor, P, Citrome, L, Bark, N, Cooper, TB. Atypical antipsychotic agents in the treatment of violent patients with schizophrenia and schizoaffective disorder. Arch Gen Psychiatry. 2006; 63(6): 622–629.Google Scholar
12.Hotham, JE, Simpson, PJD, Brooman-White, RS, etal. Augmentation of clozapine with amizulpride: an effective therapeutic strategy for violent treatment-resistant schizophrenia patients in a UK high security hospital. CNS Spectr. In press. DOI: 10.1017/S1092852913000874.Google Scholar
13.Volavka, J, Czoborb, P, Citrome, LL, Van Dorn, RA. Effectiveness of antipsychotic drugs against hostility in patients with schizophrenia in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study. CNS Spectr. In press. DOI: 10.1017/S1092852913000849.Google Scholar
14.Brown, D, Larkin, F, Sengupta, S, etal. Clozapine: an effective treatment for seriously violent and psychopathic men with antisocial personality disorder in a UK high-security hospital. CNS Spectr. In press. DOI: 10.1017/S1092852914000157.Google Scholar
15.Tiihonen, J, Lönnqvist, J, Wahlbeck, K, etal. 11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study). Lancet. 2009; 374(9690): 620–627.Google Scholar
16.Cohen, D, Bogers, JP, van Dijk, D, Bakker, B, Schulte, PF. Beyond white blood cell monitoring: screening in the initial phase of clozapine therapy. J Clin Psychiatry. 2012; 73(10): 1307–1314.Google Scholar
17.Nielsen, J, Correll, CU, Manu, P, Kane, JM. Termination of clozapine treatment due to medical reasons: when is it warranted and how can it be avoided? J Clin Psychiatry. 2013; 74(6): 603–613.Google Scholar
18.Hsieh, MM, Everhard, JE, Byrd-Holt, DD, Tisdale, JF, Rodgers, GP. Prevalence of neutropenia in the U.S. population: age, sex, smoking status, and ethnic differences. Ann Intern Med. 2007; 146(7): 486–492.Google Scholar
19.Rajagopal, S. Clozapine, agranulocytosis, and benign ethnic neutropenia. Postgrad Med J. 2005; 81(959): 545–546.Google Scholar
20.Manu, P, Sarpal, D, Muir, O, Kane, JM, Correll, CU. When can patients with potentially life-threatening adverse effects be rechallenged with clozapine? A systematic review of the published literature. Schizophr Bull. 2012; 134(2–3): 180–186.Google ScholarPubMed
21.Sockalingam, S, Shammi, C, Remington, G. Treatment of clozapine-induced hypersalivation with ipratropium bromide: a randomized, double-blind, placebo-controlled crossover study. J Clin Psychiatry. 2009; 70(8): 1114–1119.CrossRefGoogle ScholarPubMed
22.Nielsen, J, Meyer, JM. Risk factors for ileus in patients with schizophrenia. Schizophr Bull. 2012; 38(3): 592–598.CrossRefGoogle ScholarPubMed
23.Meyer, JM, Cummings, MA. Lubiprostone for treatment resistant constipation associated with clozapine use. Acta Psychiatr Scand. 2014; 130(1): 71–72.Google Scholar