Clozapine treatment and discontinuation in Iceland: A national longitudinal study using electronic patient records. (17th August 2016)

• Record Type: Journal Article
• Authors: Ingimarsson, Oddur; MacCabe, James H.; Haraldsson, Magnús; Jónsdóttir, Halldóra; Sigurdsson, Engilbert
• Is Part Of: Nordic journal of psychiatry. Volume 70:Number 6(2016)
• Page Start: 450
• Page End: 455
• Publication Date: 2016-08-17
• Subjects: Antipsychotics -- Clozapine -- Polypharmacy -- Schizophrenia -- Treatment-resistant; Psychopharmacology -- Periodicals; Psychotherapy -- Periodicals; Psychiatry -- Periodicals; Psychiatry -- Scandinavia -- Periodicals; 616.89
• DOI: 10.3109/08039488.2016.1155234
• Languages: English
• ISSNs: 0803-9488

Abstract

Abstract: Background : Clozapine is the only drug approved for treatment-resistant schizophrenia. There is evidence that clozapine is underutilized.Aims : To evaluate the initiation and discontinuation of clozapine at Landspitali University Hospital in Iceland and the prevalence of antipsychotic polypharmacy in clozapine-treated patients.Methods : The study is a part of an ongoing longitudinal study of schizophrenia in Iceland. We identified 201 patients on clozapine or who have been on clozapine by using a keyword search in the electronic health records and by reviewing their medical records.Results : Mean age at first treatment with clozapine was 37.8 years. Mean follow-up period on clozapine was 11 years. After 20 years of treatment 71.2% of patients were still on clozapine. After one year of treatment 84.4% of patients were still receiving clozapine treatment. We estimate that 11.4% of patients with schizophrenia in Iceland are taking clozapine and that 16% have been treated with clozapine at some point. Polypharmacy is common, since nearly 2/3, 65.6%, of patients taking clozapine use at least one other antipsychotic and 16.9% are also receiving depot injections.Conclusions : We need to increase the awareness of psychiatrists in Iceland with regard to treatment with clozapine, since only about half of the estimated population of patients with treatment-resistant schizophrenia in Iceland have ever been treated with clozapine. Nearly two thirds of patients who are prescribed clozapine in Iceland remain on it long-term.