A Comparison of Attitudes, Comfort, and Knowledge of Clozapine Among Two Diverse Samples of US Psychiatrists

Catatonia and Schizophrenia in a Young Man with Autism Spectrum Disorder and Clozapine-Induced Myocarditis

“…Prescriber reluctance is a major barrier to clozapine’s use. In a survey of 143 U.S. psychiatrists, 38% would rather combine two antipsychotics than use clozapine, and only 45% would use clozapine after two or fewer antipsychotic failures 9 . Efforts should be made to promote clozapine use as soon as possible without unnecessary antipsychotic trials.…”

“…In a survey of 143 U.S. psychiatrists, 38% would rather combine two antipsychotics than use clozapine, and only 45% would use clozapine after two or fewer antipsychotic failures. 9 Efforts should be made to promote clozapine use as soon as possible without unnecessary antipsychotic trials. In a survey of 86 individuals on clozapine in the southeastern United States, the median number of self-reported antipsychotic trials prior to clozapine was four.…”

“…Of all of the antipsychotics, aripiprazole has actually been reported to have been successful in the largest number of cases (9) and may be a great choice because of its partialagonist activity at the D2 receptor, which may lower the risk of worsening catatonia. 7 While the concern about inducing akathisia is certainly valid, the potential benefits of aripiprazole over other antipsychotic agents may outweigh this risk.…”

Psychiatrists' Cognitive and Affective Biases and the Practice of Psychopharmacology: Why Do Psychiatrists Differ From One Another in How They View and Prescribe Certain Medication Classes?

“…We recognize that marked differences also exist in how clinicians prescribe other classes of psychiatric medications, for example, clozapine, long-acting injectable antipsychotics, and buprenorphine ( e.g. , Cotes et al, 2022; Russell et al, 2021; Samalin et al, 2013), but for purposes of illustration, we will limit ourselves to considering stimulants and benzodiazepines.…”

“…To address these questions, the aims of this article are 1) to describe variations in psychiatrists' attitudes and prescribing patterns with respect to two classes of medications, specifically stimulants and benzodiazepines; and 2) consider factors that might account for these differences such as cognitive and affective biases and their determinants. We recognize that marked differences also exist in how clinicians prescribe other classes of psychiatric medications, for example, clozapine, long-acting injectable antipsychotics, and buprenorphine (e.g., Cotes et al, 2022;Russell et al, 2021;Samalin et al, 2013), but for purposes of illustration, we will limit ourselves to considering stimulants and benzodiazepines.…”