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Reducing the Risk of Withdrawal Symptoms and Relapse Following Clozapine Discontinuation-Is It Feasible to Develop Evidence-Based Guidelines?
- Source :
- Schizophrenia Bulletin
- Publication Year :
- 2021
-
Abstract
- Clozapine is the only antipsychotic that is effective in treatment-resistant schizophrenia. However, in certain clinical situations, such as the emergence of serious adverse effects, it is necessary to discontinue clozapine. Stopping clozapine treatment poses a particular challenge due to the risk of psychotic relapse, as well as the development of withdrawal symptoms. Despite these challenges for the clinician, there is currently no formal guidance on how to safely to discontinue clozapine. We assessed the feasibility of developing evidence-based recommendations for (1) minimizing the risk of withdrawal symptoms, (2) managing withdrawal phenomena, and (3) commencing alternatives treatment when clozapine is discontinued. We then evaluated the recommendations against the Appraisal of Guidelines for Research and Evaluation (AGREE) II criteria. We produced 19 recommendations. The majority of these recommendation were evidence-based, although the strength of some recommendations was limited by a reliance of studies of medium to low quality. We discuss next steps in the refinement and validation of an evidence-based guideline for stopping clozapine and identify key outstanding questions.
- Subjects :
- Adult
medicine.medical_specialty
Psychosis
Evidence-based practice
Time Factors
AcademicSubjects/MED00810
medicine.medical_treatment
treatment resistance
Clinical Protocols
Medicine
Humans
psychosis
Intensive care medicine
Adverse effect
Antipsychotic
Clozapine
psychopharmacology
Evidence-Based Medicine
clozapine
business.industry
Drug Substitution
withdrawal
Guideline
medicine.disease
Symptom Flare Up
Discontinuation
Substance Withdrawal Syndrome
schizophrenia
Psychiatry and Mental health
Schizophrenia
Practice Guidelines as Topic
Feasibility Studies
business
Schizophrenia, Treatment-Resistant
medicine.drug
Antipsychotic Agents
Regular Articles
Subjects
Details
- ISSN :
- 17451701
- Volume :
- 48
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Schizophrenia bulletin
- Accession number :
- edsair.doi.dedup.....a0692f018c9dfc1659d9b04d36966a69