ArticleBJPsych open2026
Causes of death and mortality patterns in clozapine-treated patients: 17-year retrospective cohort study.
Article in BJPsych open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundClozapine reduces overall mortality and suicide risk in schizophrenia, but the specific causes and clinical contexts of death among clozapine-treated patients remain less well characterised.
aimsWe aimed to characterise causes of death in clozapine-treated patients within a defined UK catchment area over 17 years (2009-2025); compare features across predefined mortality clusters (suicide, expected, unexpected); compare unexpected death cases with a clozapine-treated comparison cohort alive in 2019 and examine temporal mortality patterns.
methodWe conducted a retrospective, descriptive cohort study of all deaths among clozapine-treated patients within a UK mental health National Health Service Trust between 1 January 2009 and 31 December 2025. Deaths were classified into suicide, expected and non-intentional unexpected, using a previously established framework. Variables were compared across clusters and between unexpected death cases and a clozapine-treated comparison cohort alive in 2019.
resultsOf 87 deaths, 11 (12.6%) were suicides, 29 (33.3%) were expected and 47 (54.0%) were non-intentional unexpected. Malignancy was the most common cause (21/87, 24.1%), followed by cardiovascular (13/87, 14.9%) and respiratory or infective causes (9/87, 10.3%). Age differed across clusters (
conclusionsMortality in clozapine-treated patients arises across diverse clinical contexts, with more than half classified as non-intentional unexpected. Findings support sustained physical health monitoring, closer attention to smoking and other modifiable risks, and continuity of care.
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