A Guideline and Checklist for Initiating and Managing Clozapine Treatment in Patients with Treatment-Resistant Schizophrenia.

Content Provider	Europe PMC
Author	Correll, C. U. Agid, Ofer Crespo-Facorro, Benedicto de Bartolomeis, Andrea Fagiolini, Andrea Seppälä, Niko Howes, Oliver D.
Abstract	Treatment-resistant schizophrenia (TRS) will affect about one in three patients with schizophrenia. Clozapine is the only treatment approved for TRS, and patients should be treated as soon as possible to improve their chances of achieving remission. Despite its effectiveness, concern over side effects, monitoring requirements, and inexperience with prescribing often result in long delays that can expose patients to unnecessary risks and compromise their chances of achieving favorable long-term outcomes. We critically reviewed the literature on clozapine use in TRS, focusing on guidelines, systematic reviews, and algorithms to identify strategies for improving clozapine safety and tolerability. Based on this, we have provided an overview of strategies to support early initiation of clozapine in patients with TRS based on the latest evidence and our clinical experience, and have summarized the key elements in a practical, evidence-based checklist for identifying and managing patients with TRS, with the aim of increasing confidence in prescribing and monitoring clozapine therapy.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9243911&blobtype=pdf
ISSN	11727047
Journal	CNS Drugs
Volume Number	36
DOI	10.1007/s40263-022-00932-2
PubMed Central reference number	PMC9243911
Issue Number	7
PubMed reference number	35759211
e-ISSN	11791934
Language	English
Publisher	Springer International Publishing
Publisher Date	2022-06-27
Publisher Place	Gewerbestrasse 11, Cham, Ch 6330, Switzerland
Access Restriction	Open
Rights License	Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/. © The Author(s) 2022, corrected publication 2022
Content Type	Text
Resource Type	Article
Subject	Neurology (clinical) Pharmacology (medical) Psychiatry and Mental Health