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. 2022 Aug 6;22(1):534.
doi: 10.1186/s12888-022-04179-5.

Iranian psychiatrists' attitude towards clozapine use for patients with treatment-resistant schizophrenia: a nationwide survey

Leeba Rezaie  1 , Azadeh Nazari  2 , Roya Safari-Faramani  3 , Shamarina Shohaimi  4 , Habibolah Khazaie  5
Affiliations

Iranian psychiatrists' attitude towards clozapine use for patients with treatment-resistant schizophrenia: a nationwide survey

Leeba Rezaie et al. BMC Psychiatry. .

Abstract

Background: Clozapine has the greatest efficacy for treatment-resistant schizophrenia (TRS), even though its underutilization is not uncommon across different countries. This study aimed to investigate the knowledge and attitude of Iranian psychiatrists toward clozapine use.

Method: In this cross-sectional study, a questionnaire was distributed among psychiatrists registered with the Iranian Psychiatrists Association (including its provincial branches) to assess their knowledge and attitude towards clozapine use. A total of 282 psychiatrists completed the questionnaire. Descriptive analysis was used to describe demographic information, and Chi-square tests were conducted to determine if there is an association between academic position and work experience. All statistical analyses were performed using SPSS® version 25.0 for Windows, and a significance level of 0.05 was used.

Results: Most respondents (93%) acknowledged that they prescribed clozapine for their patients, and 74% believed that clozapine was more effective than other antipsychotic drugs. However, 43.3% of the respondents said they did not believe in the safety of clozapine. Difficulty initiating and having no firsthand experience in the superiority of clozapine were reported by 81.2 and 80% of the respondents, respectively. Our results also showed an association between having an academic position and access to appropriate facilities for the control and management of patients treated with clozapine and believing in the safety of clozapine (p < 0.05). Longer work experience (more than 15 years) was associated with a higher prescription of clozapine, belief in greater effectiveness of clozapine, and its safety (p < 0.0001).

Conclusion: Iranian psychiatrists had a good self-perception of knowledge about the efficacy of clozapine for patients with TRS, but concerns about serious side effects are common. Psychiatrists with longer work experience and academic positions were more optimistic towards clozapine use than the younger ones with no academic position. Considering the results in planning the strategies to decrease concerns about clozapine use is recommended.

Keywords: Clozapine; Iran; Treatment-resistant schizophrenia.

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Conflict of interest statement

The authors declare that they have no competing interests” in this section.

Figures

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Fig. 1
Knowledge, attitude, and experience of using clozapine
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References

    1. Kennedy JL, Altar CA, Taylor DL, Degtiar I, Hornberger JC. The social and economic burden of treatment-resistant schizophrenia: a systematic literature review. Int Clin Psychopharmacol. 2014;29:63–76. doi: 10.1097/YIC.0b013e32836508e6. - DOI - PubMed
    1. Suzuki T, Remington G, Mulsant BH, Rajji TK, Uchida H, Graff-Guerrero A, et al. Treatment-resistant schizophrenia and response to antipsychotics: a review. Schizophr Res. 2011;133:54–62. doi: 10.1016/j.schres.2011.09.016. - DOI - PubMed
    1. Correll CU, Brevig T, Brain C. Patient characteristics, burden and pharmacotherapy of treatment-resistant schizophrenia: results from a survey of 204 US psychiatrists. BMC Psychiatr. 2019;19(1):362. doi: 10.1186/s12888-019-2318-x. - DOI - PMC - PubMed
    1. Dold M, Leucht S. Pharmacotherapy of treatment-resistant schizophrenia: a clinical perspective. Evid Based Mental Health. 2014;17(2):33–37. doi: 10.1136/eb-2014-101813. - DOI - PubMed
    1. Kane J, Honigfeld G, Singer J, Meltzer H. Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine. Arch Gen Psychiatry. 1998;45:789–796. doi: 10.1001/archpsyc.1988.01800330013001. - DOI - PubMed

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