Published October 30, 2023 | Version https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue10,Article48.pdf
Journal article Open

A Cross-Sectional Survey of Clozapine Prescribing Trends Among Psychiatrists in India

  • 1. Assistant Professor, MGM Medical College, Indore
  • 2. Senior Resident, MGM Medical College, Indore
  • 3. Assistant Professor, LNCT Medical College, Indore
  • 4. Junior Resident, MGM Medical College, Indore

Description

Background: Clozapine has been found to be an effective atypical antipsychotic since the time of discovery. Clozapine was also approved by FDA for reducing the risk of suicide in schizophrenic or schizoaffective patients judged to be at chronic risk for suicidal behavior in December 2002. There is a scarcity of data from the Indian subcontinent on the preference of clozapine in the medico-surgical setting. Aims and Objective: To study the clozapine prescribing trends in various psychiatric disorders among psychiatrists in India. Methods: A survey using structured questionnaire form was done with 125 psychiatrists which included various aspects like area of practice, starting dose of clozapine, maximum dose of clozapine tried, most common side effects encountered during practice, preference of using clozapine in various disorders, monitoring side effects, most common augmentation agents, etc. Results: Majority psychiatrists have had good experience using clozapine. However, side effects and need for repeated blood investigations turned out to be a barrier for its use. Conclusion: Need to influence policy to ensure wider availability of blood investigations to ensure increased usage of clozapine while keeping it in safety checks.

 

 

 

Abstract (English)

Background: Clozapine has been found to be an effective atypical antipsychotic since the time of discovery. Clozapine was also approved by FDA for reducing the risk of suicide in schizophrenic or schizoaffective patients judged to be at chronic risk for suicidal behavior in December 2002. There is a scarcity of data from the Indian subcontinent on the preference of clozapine in the medico-surgical setting. Aims and Objective: To study the clozapine prescribing trends in various psychiatric disorders among psychiatrists in India. Methods: A survey using structured questionnaire form was done with 125 psychiatrists which included various aspects like area of practice, starting dose of clozapine, maximum dose of clozapine tried, most common side effects encountered during practice, preference of using clozapine in various disorders, monitoring side effects, most common augmentation agents, etc. Results: Majority psychiatrists have had good experience using clozapine. However, side effects and need for repeated blood investigations turned out to be a barrier for its use. Conclusion: Need to influence policy to ensure wider availability of blood investigations to ensure increased usage of clozapine while keeping it in safety checks.

 

 

 

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Dates

Accepted
2023-09-30

References

  • 1. Bunney BS. Clozapine: a hypothesised mechanism for its unique clinical profile. Br J Psychiatry Suppl: 1992;(17):17–21. 2. Kane J, Honigfeld G, Singer J, Meltzer H. Clozapine for the treatment resistant schizophrenic: A double blind comparison with chlorpromazine Arch Gen Psychiatry. 1988;45:789–96. 3. Green AI, Schildkraut JJ. Should clozapine be a first-line treatment for schizophrenia? The rationale for a double-blind clinical trial in first-episode patients Harv Rev Psychiatry. 1995;3:1–9. 4. Gareri P, De-Fazio P, De-Fazio S, Norma MN, FerreriIbbadu G, De-Sarro G. Adverse effects of atypical antipsychotics in the elderly. Drugs Aging. 2006; 23(12):937–956 3. 5. Srivastava S, Agarwal AK, Sharma M. A three-year naturalistic follow-up of patients receiving clozapine: report from India. Int J Psychiatry Clin Pract. 2002; 6:167–171. 6. Kapur S, Seeman P. Does fast dissociation from the dopamine D2 receptor explain the action of atypical antipsychotics? a new hypothesis. Am J Psychiatry 2001; 158(3):360–369. 7. Banov MD, Zarate CA Jr, Tohen M, Scialabba D, Wines JD Jr, Kolbrener M et al. Clozapine therapy in refractory affective disorders: polarity predicts response in long-term followup. J Clin Psychiatry 1994; 55(7):295–300. 8. Bernardi F, Del Zompo M. Clozapine in idiopathic Parkinson's disease. Comment Neurol 1989; 39(9):1219–1221. 9. Bonuccelli U, Ceravolo R, Maremmani C, Nuti A, Rossi G, Muratorio A. Clozapine in Huntington's chorea. Neurology 1994; 44(5): 821–823. 10. Chen NC, Bedair HS, McKay B, Bowers MB Jr, Mazure C. Clozapine in the treatment of aggression in an adolescent with autistic disorder. J Clin Psychiatry 2001;62:479–480 9. 11. De Berardis D, Serroni N, Campanella D et al. Update on the adverse efects of clozapine: focus on myocarditis. Curr Drug Saf 2012; 7:55–62. 12. Lieberman JA, Saferman AZ, Pollack S. Clinical effects of Clozapine in chronic schizophrenia: response to treatment and predictors of outcome. Am J Psychiatry 1994; 151:1744–1752. 13. Nazir D, Zaid Ahmad Wani, Bukhari F, Shabir Ahmad Dar, Yuman Kawoosa. Socio demographic, clinical, and side effect profile of patients on clozapine in Kashmir, North India. Middle East Current Psychiatry [Internet]. 2021 Dec 24 [cited 2023 Sep 11];28(1). 14. Gupta, S., Gupta, R., & Singh, V. A five-year chart review of clozapine use in. 2023.15. Khan, A., et al. Clozapine use in schizophrenic patients: A systematic review and metaanalysis. Schizophrenia Research, 2010;121(1- 3):1-13. 16. Gupta, S., Gupta, R., & Singh, V. A five-year chart review of clozapine use in individuals with schizophrenia in a general hospital psychiatric unit. Journal of Madhya Pradesh State Health Service, 2023;15(1): 1-7.