Clozapine Use in Australia

Malalagama, Geethal; Bastiampillai, Tarun; Dhillon, Rohan

doi:10.3109/10398562.2010.525646

Cited by 17 publications

(18 citation statements)

References 10 publications

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“…During phase 3 of the CATIE study, 51% of patients had previously discontinued medications due to ineffective therapeutic response, but only 11% of patients were offered clozapine during phase 3. Studies of clozapine utilization have shown that adherence to guidelines has been poor through the years with clozapine been consistently underutilized in the US, UK, Canada, New Zealand and Australia [9,21-26,42-46]. In a study of the Veterans Health Administration, only 2% of patients affected by schizophrenia were receiving clozapine [22].…”

Section: Resultsmentioning

confidence: 99%

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Clozapine: a review of clinical practice guidelines and prescribing trends

2014

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BackgroundClozapine effectiveness in the treatment of refractory schizophrenia has been sustained by published evidence in the last two decades, despite the introduction of safer options.DiscussionCurrent clinical practice guidelines have strongly recommended the use of clozapine in treatment-resistant schizophrenia, but prescribing trends do not appear to have followed such recommendations. Clozapine is still underutilized especially in patients at risk of suicide. It seems that physicians are hesitant in prescribing clozapine due to concerns about serious adverse effects. Recent reports have highlighted the need to inform health professionals about the benefits of treating patients with clozapine and have voiced concerns about the underutilization of clozapine especially in patients at risk of suicide.SummaryGuidelines and prescribing patterns reported in various countries worldwide are discussed. Suggestions on how to optimize clozapine utilization have been published but more efforts are needed to properly inform and support prescribers’ practices.

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Section: Resultsmentioning

confidence: 99%

“…In contrast, clozapine utilization in Australia appears to be more appropriate with a percentage as high as 51% of clozapine use in treatment-resistance schizophrenia [46]. …”

Section: Resultsmentioning

confidence: 99%

Clozapine: a review of clinical practice guidelines and prescribing trends

2014

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“…Data from 60% of the mental health trusts in England showed that only 30% of those eligible were actually receiving clozapine [29]. In contrast, clozapine utilization in Australia seems to be more appropriate with a percentage as high as 51% of clozapine use in TRS [30]. There have been some publications on prescription of clozapine in Turkey with an aim to promote and encourage its utilization in appropriate cases by providing an updated guide for psychiatrists who are over cautious about clozapine, which can hopefully make a positive influence on the prescribing patterns in Turkey [31,32].…”

Section: Discussionmentioning

confidence: 99%

Prescribing trends in treatment-resistant schizophrenia

Görmez

Kurtulmuş

Can

2017

Psychiatry and Clinical Psychopharmacology

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Objectives: Schizophrenia is a common mental health condition associated with significant morbidity and excess early mortality. Treatment-resistant schizophrenia (TRS) occurs in about one in three patients diagnosed with schizophrenia. The aim of this study was to identify attitudes of a nationally representative sample of psychiatrists towards pharmacotherapy of patients with TRS, the potential factors related to their choice of various regimens, and to investigate the clinical outcomes of different methods employed. Methods: Psychiatrists were contacted through national e-groups and various psychiatry conventions. They provided information about their professional and demographic characteristics. They were asked to describe clinical and demographic characteristics of an adult patient with TRS under their care for at least 3 months. They reported on the medication change they made and the effect of this intervention on the positive symptoms and functioning of the patient. Results: Among the 207 patients reported on, only 28.7% were on monotherapy for TRS immediately before the change in medication. With the change made in treatment regime, 40.1% were switched to a different antipsychotic agent as monotherapy, 40.6% received combination therapy with two or more antipsychotic agents, 1.4% received high-dose antipsychotics, and 4.8% had augmentation with antidepressants or mood stabilizers. 13.1% psychiatrists employed more than one method. Of the whole sample, 48.3% were put on clozapine either as monotherapy or with other medications. The monotherapy and combination groups were compared in terms of characteristics of patients and prescribers, which revealed no significant difference (p > .05). There was also no difference found on the outcome variables of two groups (p > .05). Conclusions: Although polypharmacy was found to be a common practice, there seemed to be a comparably good ratio of clozapine utilization and of attempts of switching to monotherapy among the prescribers. There were no significant patient-or prescriber-related factors in relation to preference of treatment regimens, which need further investigation on larger samples. ARTICLE HISTORY

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“…To calculate annual incidence rates, the figure of 11,000 was taken as the population on clozapine in each year from 2006-2010, derived by reducing the figure of 11,846 quoted by Malagama et al 2 for 2009 to allow for the trend of a gradual increase over time.…”

Section: Methodsmentioning

confidence: 99%

Clozapine and agranulocytosis: re-assessing the risks

Drew

2013

Australas Psychiatry

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During 2006-2010, without any monitoring system, the maximum annual incidence of agranulocytosis caused by clozapine would have been 0.26%. The risks of agranulocytosis, and related deaths, decreased with length of time on clozapine. During 1993-2011 141 cases of agranulocytosis, with four deaths, were recorded in association with clozapine use. The monitoring system could have successfully prevented relatively few deaths.

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Clozapine Use in Australia

Cited by 17 publications

References 10 publications

Clozapine: a review of clinical practice guidelines and prescribing trends

Clozapine: a review of clinical practice guidelines and prescribing trends

Prescribing trends in treatment-resistant schizophrenia

Clozapine and agranulocytosis: re-assessing the risks

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