Are we making the most of Clozapine?

Clozapine treatment remains the gold standard for treatment-resistant schizophrenia. Currently, clozapine use varies worldwide, from as high as 60% of psychotic patients in China to as low as 2 – 3% of psychotic patients in certain areas of the United States and Canada. Many physicians are reluctant, for a variety of reasons, to prescribe clozapine.

1. 1. To highlight to concerns physicians may have about initiating and maintaining Clozapine therapy in patients with treatment – resistant schizophrenia.

2. 2. To understand the adverse effects that are most pertinent to both physicians and their patients

To understand the barriers to prescribing Clozapine.

The authors obtained contact information for all psychiatrists registered with the College of Physicians and surgeons in Ontario, Canada. Physicians were mailed and invitation to complete a questionnaire online, or receive a paper copy, asking about potential barriers to prescribing Clozapine.

The final results of our project are still under analysis but based on the sampling done so far Clozapine therapy is limited in Ontario, Canada due to concerns of potential adverse side effects associated with clozapine therapy. There is also a limitation of access to resources to initiate and maintain patients on clozapine.

Clozapine use is still limited in many countries including Canada. Providing more education about managing the potential adverse effects and easier access to initiating and maintaining clozapine treatment will be helpful in promoting its use.