Predictors of clozapine discontinuation at 2 years in treatment-resistant schizophrenia

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dc.contributor.authorIruretagoyena, Bárbara
dc.contributor.authorCastañeda, Carmen Paz
dc.contributor.authorMena, Cristian
dc.contributor.authorDiaz, Camila
dc.contributor.authorNachar, Ruben
dc.contributor.authorRamirez, Juan Pablo
dc.contributor.authorGonzález, Alfonso
dc.contributor.authorUndurraga, Juan
dc.date.accessioned2022-03-28T13:30:23Z
dc.date.available2022-03-28T13:30:23Z
dc.date.issued2021
dc.description.abstractIntroduction: Little is known about predictors of clinical response to clozapine treatment in treatment-resistant psychosis. Most published cohorts are small, providing inconsistent results. We aimed to identify baseline clinical predictors of future clinical response in patients who initiate clozapine treatment, mainly focusing on the effect of age, duration of illness, baseline clinical symptoms and homelessness. Methodology: Retrospective cohort of patients with treatment-resistant schizophrenia, aged between 15 and 60 years, that initiated clozapine between 2014 and 2017. Sociodemographic characteristics, years from illness diagnosis, and clinical presentation before the initiation of clozapine were collected and analyzed. All-cause discontinuation at two years follow-up was used as the primary measure of clozapine response. Results: 261 patients were included with a median age at illness diagnosis of 23 years old (IQR 19-29) and a median age at clozapine initiation of 25 (IQR: 21-33). 72.33% (183/253) continued clozapine after two years follow-up. Being homeless was associated to higher clozapine non-adherence, with an OR of 2.78 (95%CI 1.051-7.38) (p = 0.039, controlled by gender). Older age at clozapine initiation and longer delay from first schizophrenia diagnosis to clozapine initiation were also associated with higher clozapine non-adherence, with each year increasing the odds of discontinuation by 1.043 (95%CI 1.02-1.07; p = 0.001) and OR 1.092 (95%CI 1.01-1.18;p = 0.032) respectively. Conclusion: Starting clozapine in younger patients or shortly after schizophrenia diagnosis were associated with better adherence.es
dc.description.versionVersión publicadaes
dc.identifier.citationIruretagoyena B, Castañeda CP, Mena C, Diaz C, Nachar R, Ramirez-Mahaluf JP, González-Valderrama A, Undurraga J, Maccabe JH, Crossley NA. Predictors of clozapine discontinuation at 2 years in treatment-resistant schizophrenia. Schizophr Res. 2021 Sep;235:102-108. doi: 10.1016/j.schres.2021.07.024es
dc.identifier.urihttps://doi.org/10.1016/j.schres.2021.07.024es
dc.identifier.urihttp://hdl.handle.net/11447/5814
dc.language.isoenes
dc.subjectClozapinees
dc.subjectSchizophreniaes
dc.subjectTreatment-delayes
dc.subjectTreatment-resistant psychosises
dc.titlePredictors of clozapine discontinuation at 2 years in treatment-resistant schizophreniaes
dc.typeArticlees
dcterms.sourceSchizophrenia researches

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