PMID- 37805277
OWN - NLM
STAT- Publisher
LR  - 20231007
IS  - 1573-2509 (Electronic)
IS  - 0920-9964 (Linking)
DP  - 2023 Oct 6
TI  - Influence of time to clozapine prescription on the clinical outcome.
LID - S0920-9964(23)00339-0 [pii]
LID - 10.1016/j.schres.2023.09.028 [doi]
AB  - BACKGROUND: This study investigates whether early clozapine use is associated 
      with improved responses in different clinical domains, including positive and 
      negative symptoms, functioning, and well-being. METHODS: Data from 254 
      clozapine-treated patients at Cambridgeshire and Peterborough NHS Foundation 
      Trust (CPFT) were analysed. Among them, 231 (90.9 %) had a diagnosis of 
      schizophrenia, 21 (8.3 %) schizoaffective disorder, and 2 (0.8 %) had other 
      diagnoses. The International Classification of Diseases-Mortality and Morbidity 
      Statistics criteria (ICD-10) were employed (World Health Organization, 1992). The 
      cohort was assessed using the positive and negative syndrome scale (PANSS), the 
      Brief Negative Symptom Scale (BNSS), Global Assessment of Functioning Scale 
      (GAF), and the short version of Warwick-Edinburgh Mental Well-being Scale 
      (SWEMWBS). Logistic regression models (for positive and negative symptom 
      remission) and linear regression (for functioning and well-being) were utilized 
      to assess the influence of time to clozapine initiation (TCI), age at the first 
      episode of psychosis (AFE), duration of clozapine treatment (DCT), and gender. 
      RESULTS: Early clozapine treatment (within the first three years after the first 
      episode of psychosis) was associated with increased negative symptom remission 
      (exp (B) = 0.38; p = 0.02) and higher functioning scores (beta = -0.12, p = 0.046). 
      However, no effect of time to clozapine initiation was found on positive symptom 
      remission rates or well-being scores. CONCLUSIONS: Initiating clozapine treatment 
      within the first 3 years of the first episode of psychosis may lead to reduced 
      severity of negative symptoms and improved functioning in clozapine-treated 
      patients. The time to clozapine initiation did not influence its effect on 
      positive symptom remission rates.
CI  - Copyright (c) 2023 Elsevier B.V. All rights reserved.
FAU - Munoz-Manchado, Leticia I
AU  - Munoz-Manchado LI
AD  - Department of Psychiatry, Behavioral and Clinical Neuroscience Institute, 
      University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS 
      Foundation Trust, Cambridge, United Kingdom; Unidad de Gestion clinica de Salud 
      Mental, Area de Gestion Sanitaria Norte de Cadiz, Hospital Universitario de Jerez 
      de la Frontera, Severe Mental Disorder Research Group, Department of 
      Neuroscience, University of Cadiz, Instituto de Investigacion e Innovacion 
      Biomedica de Cadiz (INiBICA), Cadiz, Spain. Electronic address: 
      leticia.munoz.sspa@juntadeandalucia.es.
FAU - Perez-Revuelta, Jose I
AU  - Perez-Revuelta JI
AD  - Unidad de Gestion clinica de Salud Mental, Area de Gestion Sanitaria Norte de 
      Cadiz, Hospital Universitario de Jerez de la Frontera, Severe Mental Disorder 
      Research Group, Department of Neuroscience, University of Cadiz, Instituto de 
      Investigacion e Innovacion Biomedica de Cadiz (INiBICA), Cadiz, Spain. Electronic 
      address: jose.perezrevuelta@uca.es.
FAU - Banerjee, Arka
AU  - Banerjee A
AD  - St George's University Hospitals NHS Foundation Trust, London, United Kingdom. 
      Electronic address: ab2458@cantab.ac.uk.
FAU - Galindo-Guarin, Liliana
AU  - Galindo-Guarin L
AD  - Department of Psychiatry, Behavioral and Clinical Neuroscience Institute, 
      University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS 
      Foundation Trust, Cambridge, United Kingdom. Electronic address: 
      liliana.galindoguarin@cpft.nhs.uk.
FAU - Bernardo, Miguel
AU  - Bernardo M
AD  - Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Instituto de 
      Salud Carlos III, Madrid, Spain; Barcelona Clinic Schizophrenia Unit, Hospital 
      Clinic de Barcelona, Departament de Medicina, Institut de Neurociencies 
      (UBNeuro), Universitat de Barcelona (UB), Institut d'Investigacions Biomediques 
      August Pi I Sunyer (IDIBAPS), 170, Villarroel St., 8037 Barcelona, Spain. 
      Electronic address: bernardo@clinic.cat.
FAU - Gonzalez-Saiz, Francisco
AU  - Gonzalez-Saiz F
AD  - Unidad de Gestion clinica de Salud Mental, Area de Gestion Sanitaria Norte de 
      Cadiz, Hospital Universitario de Jerez de la Frontera, Severe Mental Disorder 
      Research Group, Department of Neuroscience, University of Cadiz, Instituto de 
      Investigacion e Innovacion Biomedica de Cadiz (INiBICA), Cadiz, Spain; Centro de 
      Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Salud 
      Carlos III, Madrid, Spain. Electronic address: franciscomanuel.gonzalez@uca.es.
FAU - Villagran-Moreno, J M
AU  - Villagran-Moreno JM
AD  - Unidad de Gestion clinica de Salud Mental, Area de Gestion Sanitaria Norte de 
      Cadiz, Hospital Universitario de Jerez de la Frontera, Severe Mental Disorder 
      Research Group, Department of Neuroscience, University of Cadiz, Instituto de 
      Investigacion e Innovacion Biomedica de Cadiz (INiBICA), Cadiz, Spain; Centro de 
      Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Salud 
      Carlos III, Madrid, Spain. Electronic address: 
      jmaria.villagran.sspa@juntadeandalucia.es.
FAU - Fernandez-Egea, Emilio
AU  - Fernandez-Egea E
AD  - Department of Psychiatry, Behavioral and Clinical Neuroscience Institute, 
      University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS 
      Foundation Trust, Cambridge, United Kingdom. Electronic address: ef280@cam.ac.uk.
LA  - eng
PT  - Journal Article
DEP - 20231006
PL  - Netherlands
TA  - Schizophr Res
JT  - Schizophrenia research
JID - 8804207
SB  - IM
OTO - NOTNLM
OT  - Delay
OT  - Duration of psychosis
OT  - Negative symptoms
OT  - Remission
OT  - Treatment-resistant schizophrenia
COIS- Declaration of competing interest Dr. Munoz-Manchado has received travel support 
      from Adamed (2023), Otsuka and Neuraxpharm (2022). Perez-Revuelta has received 
      honoraria from Adamed (2023). Dr. Bernardo has received grant/research support 
      and has been on the speakers/advisory board of ABBiotics, Adamed, Angelini, Casen 
      Re-cordati, Janssen-Cilag, Menarini, Rovi and Takeda. Dr. Villagran-Moreno has 
      received consultancy honoraria from Rovi (2022) and speaker fees from Rovi (2022, 
      2023) Janssen (2022), and Adamed (2022 and 2023). Dr. Fernandez-Egea has received 
      consultancy honoraria from Boehringer-Ingelheim (2022), Atheneum (2022) and Rovi 
      (2022), speaker fees by Adamed (2022) and Otsuka (2023) and training and research 
      material from Merz (2020). The rest of the authors declare no conflict of 
      interest for this study.
EDAT- 2023/10/08 02:42
MHDA- 2023/10/08 02:42
CRDT- 2023/10/07 21:58
PHST- 2023/05/13 00:00 [received]
PHST- 2023/07/24 00:00 [revised]
PHST- 2023/09/14 00:00 [accepted]
PHST- 2023/10/08 02:42 [medline]
PHST- 2023/10/08 02:42 [pubmed]
PHST- 2023/10/07 21:58 [entrez]
AID - S0920-9964(23)00339-0 [pii]
AID - 10.1016/j.schres.2023.09.028 [doi]
PST - aheadofprint
SO  - Schizophr Res. 2023 Oct 6:S0920-9964(23)00339-0. doi: 
      10.1016/j.schres.2023.09.028.