Reason for clozapine cessation.
OBJECTIVE
Approximately 30% of individuals diagnosed with schizophrenia suffer from treatment-resistant or refractory schizophrenia. The gold standard for treatment of refractory schizophrenia is clozapine. However, a significant number of patients cease clozapine therapy; therefore this study explores patient's motives for cessation.


METHODS
The motives for cessation and duration of clozapine treatment from a retrospective database of 151 patients with schizophrenia or schizo-affective disorder who had ceased clozapine once or more were reviewed, with the motives for cessation coded. The general motives for cessation were non-compliance, own decision, medical, poor response and other. In addition, the medical reasons for cessation were further codified: cardiac complications, neutropenia, fevers, other side effects and pregnancy.


RESULTS
The majority of patients ceased clozapine owing to non-compliance with medical protocols or citing their own decision. Approximately half ceased after a period of 6 months or less. Seventeen per cent of patients ceased owing to medical reasons, with the largest proportions discontinuing treatment because of other side effects or neutropenia.


CONCLUSIONS
Future research should seek to further investigate why patients decide to be non-compliant and formulate their own decision to cease treatment, as this will facilitate strategies to promote adherence amongst these two groups that are potentially the most amenable to change.
Illawarra Health Medical Research Institute, University of Wollongong, New South Wales, Australia. nagesh@uow.edu.au
N B
NB
Pai
S C
SC
Vella
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects; D003024:Clozapine / Q000008:administration & dosage / Q000009:adverse effects; D004351:Drug Resistance; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D009042:Motivation; D009503:Neutropenia / Q000139:chemically induced; D010817:Physician-Patient Relations; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000139:chemically induced; D011618:Psychotic Disorders / Q000188:drug therapy*; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology
D014150:Antipsychotic Agents; D003024:Clozapine