What Is the Place of Clozapine in the Treatment of Early Psychosis in Canada?

TitleWhat Is the Place of Clozapine in the Treatment of Early Psychosis in Canada?
Publication TypeJournal Article
Year of Publication2017
AuteursWilliams, R, Malla, A, Roy, M-A, Joober, R, Manchanda, R, Tibbo, P, Banks, N, Agid, O
JournalCan J Psychiatry
Date Published2017 Feb
KeywordsAntipsychotic Agents, Canada, Clozapine, Humans, Psychotic Disorders

Research and development of early intervention (EI) services for first-episode psychosis have brought much-needed transformation of service delivery for this serious mental disorder to many jurisdictions. The effectiveness of the EI model of service delivery is contingent on timely access to all evidence-informed treatment interventions, including a rational approach to pharmacotherapy. In this perspective paper, we present a brief review of the well-established effectiveness of clozapine in patients who clearly show lack of response to regular antipsychotic therapy. We concentrate, in particular, on the need to identify eligibility for clozapine therapy very early on following failure of treatment on 2 antipsychotic medications. We suggest that attention to the low use of clozapine in the very early phase of treatment of psychosis may be of particular value, as the response to clozapine at this stage is likely to produce larger benefits in other domains of outcomes because of the greater retention of patients' personal and social agency.

Alternate JournalCan J Psychiatry
PubMed ID27310245
PubMed Central IDPMC5298522