Comparison of clozapine response for inpatients in the research setting versus routine clinical practice.
OBJECTIVE
This study compares patient characteristics and treatment response between inpatients treated with clozapine in a research setting as compared to those initiated on clozapine during routine inpatient treatment.


METHODS
Subjects on clozapine, in clinical trials, were compared with clozapine inpatients receiving routine clinical care.


RESULTS
At baseline, patients in routine clinical practice had more negative symptoms (P < 0.001), activation (P < 0.001) and greater total Brief Psychiatric Rating Scale (BPRS) scores (P = 0.022) than those in the research setting. Routine clinical practice subjects had larger decreases in BPRS total scores (P = 0.042) and positive item scores (P = 0.0005) compared to research subjects. Response to clozapine was observed in 15/85 (18%) research subjects as compared to 60/223 (27%) patients in routine care (P = 0.09).


CONCLUSIONS
Patients treated in routine clinical practice have more severe baseline symptoms, but experience significantly greater improvements in psychiatric symptoms.
Boggs
Douglas L
DL
Maryland Psychiatric Research Center, School of Medicine, University of Maryland-Baltimore, Baltimore, MD 21228, USA. dboggs@mprc.umaryland.edu
Kelly
Deanna L
DL
Love
Raymond C
RC
McMahon
Robert P
RP
Conley
Robert R
RR
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D010054:Brief Psychiatric Rating Scale / Q000706:statistics & numerical data; D003024:Clozapine / Q000627:therapeutic use*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D035842:Research Subjects / Q000523:psychology*; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D003024:Clozapine