Clozapine use by patients with treatment-resistant schizophrenia appears to have a protective effect against self-harm when compared with other antipsychotics, according to a report in AJP in Advance. The study also found that when compared with no antipsychotic treatment, clozapine use is associated with a decreased overall mortality rate.
Researchers in England and Denmark conducted a population-based cohort study of 2,370 individuals born in Denmark, who had been diagnosed with treatment-resistant schizophrenia after January 1, 1996. Patients were followed until death, first episode of self-harm, emigration, or June 1, 2013.
During the follow-up period, 1,372 individuals (58%) with treatment-resistant schizophrenia initiated clozapine treatment. After adjusting for confounding factors, nonclozapine antipsychotic treatment was associated with an elevated rate of self-harm (hazard ratio: 1.36) compared with clozapine. Moreover, the absence of clozapine treatment was associated with an elevated rate of all-cause mortality (hazard ratio: 1.88) compared with clozapine treatment. “This was driven mainly by periods of no antipsychotic treatment (hazard ratio: 2.50), with nonsignificantly higher mortality during treatment with other antipsychotics (hazard ratio: 1.45),” Theresa Wimberley, Ph.D., of Aarhus University in Denmark and colleagues wrote.