Perspectives of clozapine-naïve outpatients with treatment-resistant schizophrenia on clozapine commencement: a mixed-methods convergent study

Patients tend to prefer the predictability in status quo over switching to clozapine if they previously have trialled multiple APs with inadequate symptom reduction and subsequent deterioration/rehospitalisation or AP-induced weight gain and sedation. Moreover, the impression that clozapine treatment was unmanageable or a last-resort option further accentuated their reluctance to switch. Antipsychotic-trial fatigue and the stigma of clozapine as a last-resort treatment should be avoided by adhering to guidelines, thereby limiting the number of antipsychotics trialled before offering clozapine. Fortunately, it seems as if the patient's willingness to trial clozapine is positively impressionable to the conversation about customised commencement plans offering commencement on the patient's terms. For patients with subjective distress due to their symptoms, such plans can even reverse an initial clozapine refusalCite Now.