This study looked across large national registries of >500,000 individuals to explore how clozapine performs—not just in schizophrenia, but across a broad range of psychiatric disorders including schizoaffective, delusional, bipolar, major depressive and borderline-personality disorders. The authors compared clozapine with other antipsychotic treatments (and with mood stabilisers in bipolar disorder) using a within-individual design to reduce bias.
Key findings
Luykx and colleagues found that clozapine was associated with reduced psychiatric hospitalisations compared with other oral antipsychotics. This was found in all disorders studied, except for borderline personality disorder. For other outcomes, such as all-cause discontinuation, clozapine also outperformed other antipsychotics. For bipolar disorder, clozapine also outperformed mood-stabilisers and other antipsychotics. Additionally, clozapine use was found to be as safe or safer than other antipsychotics.
Why this matters
These results suggest that clozapine’s benefits extend beyond the traditional scope of schizophrenia-spectrum disorders, e.g. into severe affective disorders. Given the consistency of findings across two large national cohorts, this has potential implications for treatment guidelines and clinical decision-making in severe mental illness.’
Read the publication in The Lancet Psychiatry: Transdiagnostic effectiveness and safety of clozapine in individuals with psychotic, affective, and personality disorders: nationwide and meta-analytic comparisons with other antipsychotics.
Source: Psychiatry Amsterdam
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