Department of Psychosis Studies, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
Br J Psychiatry. 2012 Dec;201(6):481-5. doi: 10.1192/bjp.bp.111.105833. Epub 2012 Sep 6.
Clozapine is the only antipsychotic drug licensed for treatment-resistant schizophrenia but its use is often delayed. Since previous studies, national guidelines on the use of clozapine and other antipsychotics have been disseminated to clinicians.
To determine the theoretical delay to clozapine initiation and to quantify the prior use of antipsychotic polypharmacy and high-dose antipsychotic treatment.
Clinico-demographic data were extracted from the treatment records of all patients commencing clozapine in our centre between 2006 and 2010.
Complete records were available for 149 patients. The mean theoretical delay in initiating clozapine was 47.7 months (s.d. = 49.7). Before commencing clozapine, antipsychotic polypharmacy and high-dose treatment was evident in 36.2 and 34.2% of patients respectively. Theoretical delay was related to illness duration (β = 0.7, P<0.001) but did not differ by gender or ethnicity.
Substantial delays to clozapine initiation remain and antipsychotic polypharmacy and high doses are commonly used prior to clozapine, despite treatment guidelines.
氯氮平是唯一获准用于治疗难治性精神分裂症的抗精神病药物，但它的使用往往被延迟。由于之前的研究，国家关于氯氮平和其他抗精神病药物使用的指南已经分发给临床医生。
确定氯氮平起始治疗的理论延迟，并量化抗精神病药物联合用药和高剂量抗精神病药物治疗的先前使用情况。
从我们中心 2006 年至 2010 年间开始使用氯氮平的所有患者的治疗记录中提取临床人口统计学数据。
149 名患者的完整记录可用。理论上开始氯氮平治疗的平均延迟为 47.7 个月（标准差=49.7）。在开始氯氮平治疗之前，分别有 36.2%和 34.2%的患者使用了抗精神病药物联合用药和高剂量治疗。理论延迟与疾病持续时间有关（β=0.7，P<0.001），但与性别或种族无关。
尽管有治疗指南，但氯氮平起始治疗的延迟仍然很大，并且在开始氯氮平治疗之前，经常使用抗精神病药物联合用药和高剂量。
