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

Research output: Contribution to journalReview articlepeer-review

Original languageEnglish
JournalSchizophrenia Bulletin Open
Accepted/In press20 Jun 2022
Published10 Jul 2022

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King's Authors

Abstract

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

Method
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.

Results
Thirteen studies were included with a total of 1,487 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 where mentioned, focused on blood tests and common side effects, including hypersalivation and weight gain.

Conclusions
This is the first systematic review exploring patients’ subjective experiences of clozapine for TRS. Findings suggest that patients generally have a favourable 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.

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