The lived experience of clozapine discontinuation in patients and carers following suspected clozapine-induced neutropenia

Ebenezer Oloyede*, Danielle Dunnett, David Taylor, Ivana Clark, James H. MacCabe, Eromona Whiskey, Juliana Onwumere

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Clozapine is the treatment of choice in refractory psychosis. In most countries, clozapine must be stopped indefinitely if white blood cells fall below a defined threshold during routine monitoring. Despite evidence of severe adverse consequences of clozapine discontinuation, published accounts on the lived experiences and perspectives of patients and carers are scarce. Method: We completed semi-structured interviews with patients (n = 4) and family carers (n = 4) on experiences of clozapine cessation following suspected drug-induced neutropenia. Interviews were audio-recorded, transcribed and analysed thematically. Results: The two overarching themes comprised:(i) stress of clozapine below threshold neutrophil results and (ii) patient and carer priorities. Conclusions: There is a suggested need for evidence-based pharmacological and psychological approaches to support patients and carers after clozapine cessation. Such approaches will minimise the potentially negative physical and emotional sequela in the aftermath of a below threshold neutrophil result and reduce the likelihood of experiencing additional health and social inequalities after clozapine discontinuation.

Original languageEnglish
Article number413
JournalBMC Psychiatry
Volume23
Issue number1
Early online date8 Jun 2023
DOIs
Publication statusPublished - Dec 2023

Keywords

  • Clozapine
  • Discontinuation
  • Neutropenia

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