Authors: Alice Weatherston
New findings, published recently in the American Journal of Psychiatry, have revealed that clozapine may be the best alternative when patients are unresponsive to standard antipsychotic medications for schizophrenia. The research was carried out at Columbia University Medical Center (NY, USA).
Schizophrenia affects up to 1% of the adult population in the USA, but despite antipsychotics successfully relieving symptoms in most patients, up to 30% of patients have treatment-resistant schizophrenia.
Prior to this study, clozapine was often considered a last resort for schizophrenia patients due to concerns over the risk of agranulocytosis, despite it being the only medication approved by the FDA for treatment-resistant schizophrenia.
Utilizing USA Medicaid data from 6246 patients who exhibited treatment-resistance, the current study directly compared the efficacy of clozapine with standard antipsychotics used in the population.
Results indicated that patients who were switched to clozapine as opposed to another standard antipsychotic experienced fewer hospitalizations, stayed on medication longer and were less likely to require usage of additional antipsychotics.
The FDA recently broadened access to clozapine making the results of the study timely in the development of alternative treatment options for schizophrenia patients. Agranulocytosis can now be monitored closely and reliably through white blood cell levels, reducing the need for such restrictive measures on the drug’s use and expanding the decision-making process to be reliant on assessment of the benefits and risks for individual patients.
“These results give clinicians important guidance for how to help an extremely vulnerable group of people,” commented lead author of the study Scott Stroup (Columbia University Medical Center). “By helping individuals with treatment-resistant schizophrenia get effective treatment sooner we can expect better outcomes.”