Clozapine: prescribing practices in French psychiatric hospitals, multicenter survey on a given day

Introduction Efficacy of clozapine has now been proven for all symptoms of resistant schizophrenia. Yet it remains underused in view of the prevalence of drug resistance and unevenly prescribed worldwide despite a general trend towards increasing prescribing (Bachmann et al. Acta Psychiatr Scand 2017; 1-15). Data on hospital clozapine prescribing in France are older and single-center (Mercier et al. L’Encéphale 2009; 35, 321-329). Collaboration between a national multi-professional network (pharmacist, general practitioner, psychiatrist) working in various public or private mental health establishments (the PIC network) and a regional psychiatric research federation (FERREPSY Occitanie) has enabled a broad and up-to-date study of practices. Objectives To assess the prevalence of clozapine prescribing among patients hospitalised in full-time psychiatry on a given day. To assess the prevalence of clozapine prescribing in inpatients with a diagnosis of non-organic psychotic disorder (ICD 10: F20-F29). To study the characteristics of patients treated, prescribing methods and clinical monitoring. Methods A cross-sectional observational study was carried out in December 2023 with teams from establishments belonging to the PIC and/or FERREPSY network who had volunteered. Results 30 centers took part in the study, with a total of 795 patients included. The average age was 44.1 years (66% men and 34% women). 14.05% of hospitalised patients were receiving clozapine treatment on the day of the survey. 25.07% of patients with a diagnosis of non-organic psychotic disorder were receiving clozapine treatment. 26.83% of clozapine prescriptions were off-label, mainly for patients with mood disorders. 91.94% of patients had had their blood pressure measured in the quarter preceding the survey, and 91.82% had been weighed. Conversely, only 31.94% had their umbilical circumference measured. Conclusions This study found that the prevalence of prescribing among patients with non-organic psychotic disorders in the hospital was higher than expected, according to European data on clozapine prescription Further data on outpatient use are still required. Disclosure of Interest None Declared