Delay in starting clozapine in treatment resistant schizophrenia

Quoting from article.

WHAT WERE THE FINDINGS?

The researchers determined that initiating clozapine treatment and duration of clozapine treatment were independent contributors of improvement in TRS symptoms. Furthermore, ROC curve analysis showed that 2.8 years was the cutoff for predicting clozapine efficacy at treating TRS symptoms.

This data showed that patients who received clozapine within 2.8 years of the onset of TRS had a treatment response rate of 81.6%. If the patient received clozapine with a greater than 2.8 years delay they had a response rate of only 30.8%. In addition, patients who received clozapine within 2.8 years were less likely to then receive electroconvulsive treatment (5%) than compared to patients who received clozapine 2.8 years after onset (23%).

VERY interesting article. My son was tried on so many different APs that sometimes showed initial results, but would fail within months. I had started asking his pdoc about clozapine well before it was tried. Actually… I think the biggest reason it was tried was because his usual pdoc was on vacation when my son was hospitalized and another partner of his decided to switch to it. I think it definitely was initiated because the partner was more predisposed to try clozapine.

The first trial of clozapine was well outside the finding of 2.8 years after onset. It has worked well. My son still has many symptoms, but our lives have improved significantly.

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