Clozapine prescribing in the UK: views and experience of consultant psychiatrists

Tungaraza, Tongeji E.; Farooq, Saeed

doi:10.1177/2045125314566808

Cited by 51 publications

(56 citation statements)

References 41 publications

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“…Tungaraza and Farooq () conducted a survey of consultant psychiatrists and of the 243 responses, over half (56.2%) experienced difficulties in getting patients and carers to agree to a trial of clozapine and 40.5% reported a preference in prescribing several trials of other antipsychotics prior to consideration of clozapine. It was also noted that 36.2% reported difficulty in identifying patients eligible for clozapine treatment.…”

Section: Resultsmentioning

confidence: 99%

Delays and barriers to the commencement of clozapine in eligible people with a psychotic disorder: A literature review

Thien

O’Donoghue

2018

Early Intervention Psych

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Section: Resultsmentioning

confidence: 99%

Delays and barriers to the commencement of clozapine in eligible people with a psychotic disorder: A literature review

Thien

O’Donoghue

2018

Early Intervention Psych

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“…However, some studies underline that clinician-related factor are a main contribuitor to the low rates of clozapine prescription, as consultant psychiatrists may have little knowledge about certain aspects of clozapine, like its capacity to reduce suicide or drug abuse in patients with schizophrenia, and few experience in treating patients with this drug, since a significant number of the psychiatrists interviewed claimed to have had less than five patient on clozapine therapy 36,37 .…”

Section: Discussionmentioning

confidence: 99%

Patterns of clozapine and other antipsychotics prescriptions in patients with treatment-resistant schizophrenia in community mental health centers in São Paulo, Brazil

Silveira¹,

Rocha²,

Àttux³

et al. 2015

Arch. Clin. Psychiatry (São Paulo)

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Background: Despite of its global underuse, clozapine is still the golden standard antipsychotic for patients with treatment-resistant schizophrenia (TRS). Objective: To evaluate the patterns of clozapine and other antipsychotic drugs prescription in TRS in community mental health centers in São Paulo, Brazil. Methods: A multiple-choice questionnaire was applied to fifteen psychiatrists at five centers inquiring about patients' clinical condition, adherence to oral treatment and current antipsychotic treatment. History of previous and current antipsychotic treatment was collected through medical chart review. Results: Out of 442 schizophrenia patients, 103 (23.3%) fulfilled the criteria for TRS. Fifty-eight patients (56.3%) were receiving polypharmacy; 30 (29.1%) were on atypical antipsychotic monotherapy, 14 (13.6%) were on typical antipsychotic monotherapy, 25 (24.3%) were taking depot antipsychotic medication and only 22 (21.4%) were receiving clozapine. Discussion: As well as in other parts of the world, many TRS patients (78.6%) receive other drugs instead of clozapine in São Paulo, the best evidence-based medication for patients with TRS. The government should make every effort to provide medical training and the equipment and logistic support to adequately serve those who could benefit from clozapine treatment at the community health centers.

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“…5 Not only is clozapine underused; its prescription is decreasing in some countries, and initiation is delayed. [6][7][8][9][10] The reasons for this reduction range from the life-threating risks of agranulocytosis 11 and myocarditis 12 to highly disturbing hypersialorrhea 13 and constipation.…”

Section: Introductionmentioning

confidence: 99%

“…5 Departamento de Clínica Médica, UFSC, Florianópolis, SC, Brazil. 6 Programa de Pós-Graduação em Ciências da Saúde, UNISUL, Palhoça, SC, Brazil. * These authors have contributed equally to this manuscript.…”

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Trends in the prescription of clozapine in a psychiatric hospital: a 5-year observational study

Niehues

Balan

Diaz

et al. 2017

Trends Psychiatry Psychother.

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Introduction Clozapine is a well-recognized effective treatment for some patients with treatment-resistant schizophrenia (TRS). Although it has potential benefits and approximately 30% of patients have a clinical indication for clozapine use, prescription rates are low. Objective To evaluate clozapine prescription trends over a 5-year period in a tertiary psychiatric hospital. Methods In this observational study, data prospectively collected by the Medical and Statistical File Service (Serviço de Arquivo Médico e Estatístico) and the Pharmacy Division of Instituto de Psiquiatria de Santa Catarina between January 2010 and December 2014 were summarized and analyzed by investigators blinded to data collection. The number of 100 mg clozapine pills dispensed by the Pharmacy Division to the inpatient units was the outcome and considered a proxy measure of clozapine prescriptions. The number of occupied inpatient unit beds and the number of patients admitted with F20-F29 (ICD-10) diagnoses during the study period were considered to be possible confounders. Results A multiple linear regression model showed that time in months was independently associated with an increase in the number of clozapine pills dispensed by the Pharmacy Division (β coefficient = 15.82; 95% confidence interval 10.88-20.75). Conclusion Clozapine prescriptions were found to have increased during the 5-year period studied, a trend that is opposite to reports from several other countries.

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Clozapine prescribing in the UK: views and experience of consultant psychiatrists

Abstract: Important areas of concern such as managing side effects and deficiency in evidence-based use of clozapine were identified. These can be targeted in training and professional development programme.

Cited by 51 publications

References 41 publications

Delays and barriers to the commencement of clozapine in eligible people with a psychotic disorder: A literature review

Delays and barriers to the commencement of clozapine in eligible people with a psychotic disorder: A literature review

Patterns of clozapine and other antipsychotics prescriptions in patients with treatment-resistant schizophrenia in community mental health centers in São Paulo, Brazil

Trends in the prescription of clozapine in a psychiatric hospital: a 5-year observational study

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