ArticleThe international journal of neuropsychopharmacology2022
Clozapine Treatment Is Associated With Higher Prescription Rate of Antipsychotic Monotherapy and Lower Prescription Rate of Other Concomitant Psychotropics: A Real-World Nationwide Study.
Article in The international journal of neuropsychopharmacology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 26 citations in OpenAlex.
- Eight-Year Progression of Clinical Practice Implementation Following Guideline Training in the EGUIDE Project.Neuropsychopharmacology reports · 2026Observational
- Review
- Association between pharmacological guideline adherence and actigraphy-measured sleep variables in long-term hospitalized patients with schizophrenia.PCN reports : psychiatry and clinical neurosciences · 2025Article
- Associations between clozapine availability, the diagnosis of treatment-resistant schizophrenia subgroups, antipsychotic monotherapy, and concomitant psychotropics among patients with schizophrenia: a real-world nationwide study.The international journal of neuropsychopharmacology · 2025Article
- The association between benzodiazepine prescriptions and the risk of laxative use in schizophrenia treatment.Neuropsychopharmacology reports · 2025Article
- Current status and features of antipsychotic prescriptions in Japanese forensic psychiatric wards based on a forensic inpatient database.Neuropsychopharmacology reports · 2025Article
- Clozapine for Patients With Intellectual Disabilities: A Case Series Illustrating the Clinical Potentials.Case reports in psychiatry · 2025Article
- Effect of Organic Anion Transporting Polypeptide 1B1 on Plasma Concentration Dynamics of Clozapine in Patients with Treatment-Resistant Schizophrenia.International journal of molecular sciences · 2024Article
- Effect of education regarding treatment guidelines for schizophrenia and depression on the treatment behavior of psychiatrists: A multicenter study.Psychiatry and clinical neurosciences · 2023Article
- Association of clozapine treatment and rate of methamphetamine or amphetamine relapses and abstinence among individuals with concurrent schizophrenia spectrum and amphetamine use disorder: A retrospective cohort study.Journal of psychopharmacology (Oxford, England) · 2023Article
- Data Mining for Risks of Clozapine Side Effects, Including Neutropenia, Associated with Lithium Carbonate Administration: Analysis Using the Japanese Adverse Drug Event Report Database.Drugs - real world outcomes · 2023Article
- Article
- Second to none: rationale, timing, and clinical management of clozapine use in schizophrenia.Therapeutic advances in psychopharmacology · 2023Review
- The characteristics of discharge prescriptions including pro re nata psychotropic medications for patients with schizophrenia and major depressive disorder from the survey of the "Effectiveness of guidelines for dissemination and education in psychiatric treatment (EGUIDE)" project.Annals of general psychiatry · 2022Article
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Authors and funding
36 authors at 20 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough clozapine is effective for treatment-resistant schizophrenia (TRS), the rate of clozapine prescription is still low. Whereas antipsychotic monotherapy is recommended in clinical practice guidelines, the rate of antipsychotic polypharmacy is still high. There is little evidence on whether a clozapine prescription influences changes in the rate of monotherapy and polypharmacy, including antipsychotics and other psychotropics. We therefore hypothesized that the rate of antipsychotic monotherapy in patients with TRS who were prescribed clozapine would be higher than that in patients with schizophrenia who were not prescribed clozapine.
methodsWe assessed 8306 patients with schizophrenia nationwide from 178 institutions in Japan from 2016 to 2019. We analyzed the psychotropic prescription data at discharge in patients diagnosed with TRS and with no description of TRS (ND-TRS) based on the diagnosis listed in the discharge summary.
resultsThe rate of antipsychotic monotherapy in the TRS with clozapine group (91.3%) was significantly higher than that in the TRS without clozapine group (45.9%; P < 2.0 × 10-16) and the ND-TRS without clozapine group (54.7%; P < 2.0 × 10-16). The rate of antipsychotic monotherapy without any other concomitant psychotropics in the TRS with clozapine group (26.5%) was significantly higher than that in the TRS without clozapine group (12.6%; P = 1.1 × 10-6) and the ND-TRS without clozapine group (17.0%; P = 5.9 × 10-6).
conclusionsClozapine prescription could be associated with a high rate of antipsychotic monotherapy. Patients will benefit from the correct diagnosis of TRS and thus from proper clozapine prescription.
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