Patients’ Experiences of Clozapine for Treatment-Resistant Schizophrenia: A Systematic Review

Steven Parkes*, Bethany Mantell, Ebenezer Oloyede, Graham Blackman

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

10 Citations (Scopus)
207 Downloads (Pure)


Clozapine is the most effective antipsychotic for patients with treatment-resistant schizophrenia (TRS), however, it remains widely under-utilized in clinical practice. To date, relatively little attention has been given to patients’ experience of clozapine. By synthesizing the existing literature, we sought to determine the experiences of patients with TRS treated with clozapine.

A systematic review was conducted on Embase, Medline, PsychInfo, and PubMed databases for studies from 1956 to 2021. English language studies and those based on adult patients prescribed clozapine for TRS were included.

Thirteen studies were included with a total of 1487 patients and a narrative synthesis was performed. Overall, most patients reported positive experiences of clozapine, with generally high levels of satisfaction, alongside symptom improvement and preference over previous medications. Negative experiences of clozapine were less common, but when mentioned, focused on blood tests and common side effects, including hypersalivation and weight gain.

This is the first systematic review exploring patients’ subjective experiences of clozapine for TRS. Findings suggest that patients generally have a favorable experience when being treated with clozapine. However, conclusions are limited by the risk of bias, particularly survivorship bias. High-quality longitudinal studies exploring patients’ experiences of clozapine are indicated for the future.
Original languageEnglish
Article numbersgac042
JournalSchizophrenia Bulletin Open
Issue number1
Publication statusPublished - 10 Jul 2022


  • psychosis
  • antipsychotics
  • treatment-resistance
  • Subjective experience


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