Clozapine audit: What do patients and relatives think?

Abstract

Clozapine has been shown to be effective in up to 60% of patients with previously treatment resistant schizophrenia. There is a 3% risk of neutropenia and the associated requirement for regular haematological monitoring contributes to clozapine's high cost. This leads to pressure to stop treatment if quantifiable improvement does not occur. However, traditional outcome measures such as the BPRS do not incorporate the opinions of the patients or their relatives. We found patients and relatives were more positive than ward staff about clozapine treatment and they often highlighted changes that had gone unnoticed by ward staff. The findings of this study suggest that, unless these opinions are actively sought before treatment is withdrawn, many patients could be denied the benefits of clozapine.