ArticleSchizophrenia bulletin2022
Reducing the Risk of Withdrawal Symptoms and Relapse Following Clozapine Discontinuation-Is It Feasible to Develop Evidence-Based Guidelines?
Article in Schizophrenia bulletin, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A Guideline and Checklist for Initiating and Managing Clozapine Treatment in Patients with Treatment-Resistant Schizophrenia.CNS drugs · 2022Guideline
- A Scoping Review of Methods, Guidelines, and Protocols Used for Dose Reduction or Discontinuation of Antipsychotic Medication in People Affected by Psychotic Disorders.Schizophrenia bulletin · 2026Article
- Clozapine Dose Reduction in Remitted Patients With Treatment-Resistant Schizophrenia: A Case Series.Schizophrenia bulletin · 2026Article
- Tapering and withdrawing opioids: guidance informed by fundamental principles to minimise withdrawal symptoms.Therapeutic advances in psychopharmacology · 2025Review
- Identifying clinically relevant agranulocytosis in people registered on the UK clozapine Central Non-Rechallenge Database: retrospective cohort study.The British journal of psychiatry : the journal of mental science · 2024Article
- A Case of Clozapine-Induced Hepatotoxicity: Management Considerations and Future Direction.Cureus · 2024Article
- Review
- Effective and safe use of intramuscular clozapine in a patient presenting with catatonia and thrombocytopenia.BMJ case reports · 2024Article
- Using in silico methods to determine optimal tapering regimens for decanoate-based long-acting injectable psychosis drugs.Therapeutic advances in psychopharmacology · 2024Article
- The lived experience of clozapine discontinuation in patients and carers following suspected clozapine-induced neutropenia.BMC psychiatry · 2023Article
- What are the barriers and facilitators of clozapine use in early psychosis? A survey of UK early intervention clinicians.Schizophrenia (Heidelberg, Germany) · 2023Article
- Implementing gradual, hyperbolic tapering of long-acting injectable antipsychotics by prolonging the inter-dose interval: anTherapeutic advances in psychopharmacology · 2023Review
- Second to none: rationale, timing, and clinical management of clozapine use in schizophrenia.Therapeutic advances in psychopharmacology · 2023Review
- Clozapine haematological monitoring for neutropenia: a global perspective.Epidemiology and psychiatric sciences · 2022Review
- Clozapine augmentation with cariprazine for negative symptoms: a case series and literature review.Therapeutic advances in psychopharmacology · 2022Article
- Letter to the FDA Proposing Major Changes in the US Clozapine Package Insert Supported by Clozapine Experts Worldwide. Part I: A Review of the Pharmacokinetic Literature and Proposed Changes.Journal of clinical psychopharmacologyReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Clozapine is the only antipsychotic that is effective in treatment-resistant schizophrenia. However, in certain clinical situations, such as the emergence of serious adverse effects, it is necessary to discontinue clozapine. Stopping clozapine treatment poses a particular challenge due to the risk of psychotic relapse, as well as the development of withdrawal symptoms. Despite these challenges for the clinician, there is currently no formal guidance on how to safely to discontinue clozapine. We assessed the feasibility of developing evidence-based recommendations for (1) minimizing the risk of withdrawal symptoms, (2) managing withdrawal phenomena, and (3) commencing alternatives treatment when clozapine is discontinued. We then evaluated the recommendations against the Appraisal of Guidelines for Research and Evaluation (AGREE) II criteria. We produced 19 recommendations. The majority of these recommendation were evidence-based, although the strength of some recommendations was limited by a reliance of studies of medium to low quality. We discuss next steps in the refinement and validation of an evidence-based guideline for stopping clozapine and identify key outstanding questions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.