Korean J Schizophr Res.  2021 Apr;24(1):36-43. 10.16946/kjsr.2021.24.1.36.

Change of Prescribing Pattern after Clozapine Discontinuation: A Retrospective Chart Review

• Kang SH

• KMID: 2515679
• DOI: http://doi.org/10.16946/kjsr.2021.24.1.36

Abstract

Objectives
Despite the high discontinuation rate of clozapine in refractory schizophrenia, there is limited evidence regarding the suggested treatment after clozapine discontinuation.
Methods
The medical records of 37 patients who discontinued clozapine were retrospectively reviewed. The prescription patterns of antipsychotics, mood stabilizers, and antidepressants were compared at three points before and after clozapine treatment and at the most recent visit.
Results
After clozapine discontinuation, 75.6% of the subjects were receiving antipsychotic polypharmacy, and 32.4% were taking more than 3 antipsychotics. The frequently used antipsychotics were olanzapine (21.5%), quetiapine (21.5%), and paliperidone (12.7%). The rates of augmentation with mood stabilizers and antidepressants were 43.2% and 29.7%, respectively. Furthermore, valproate was the most commonly used mood stabilizer (87.5%).
Conclusion
Antipsychotic polypharmacy and augmentation are inevitable in schizophrenia patients for whom clozapine has been discontinued. Further research is required to improve the outcomes of polypharmacy and augmentation in schizophrenia patients.

Keyword

Augmentation; Clozapine; Discontinuation; Polypharmacy; Prescribing pattern; Schizophrenia; 강화 요법; 클로자핀; 중단; 다제약물처방; 처방 패턴; 조현병

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