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Evidence to Improve Care

Schizophrenia

Care for Adults in Hospitals

6

Treatment With Clozapine

Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia who have failed to respond to previous adequate trials of treatment with two antipsychotic medications are offered clozapine.


Clozapine has been demonstrated to be highly effective and is the treatment of choice if someone with schizophrenia has a partial or total nonresponse to other antipsychotic treatments.

For Patients

If you have tried at least two different antipsychotic medications and your symptoms have not improved, you should be offered clozapine. Clozapine is taken orally.


For Clinicians

Offer people with schizophrenia clozapine if they have tried two antipsychotic medications without success.


For Health Services

Through adequately resourced systems and services, ensure that clinicians are able to offer clozapine as a treatment for people with schizophrenia who are admitted to hospital.

Process Indicator

Percentage of adults admitted to hospital with a primary diagnosis of schizophrenia who have not responded adequately to treatment with at least two antipsychotic medications and who are offered clozapine

  • Denominator: total number of adults admitted to an inpatient setting with a primary diagnosis of schizophrenia who have not responded adequately to treatment with at least two antipsychotic medications

  • Numerator: number of people in the denominator who are offered clozapine while in hospital

  • Data source: local data collection

Percentage of adults admitted to hospital with a primary diagnosis of schizophrenia who did not respond adequately to treatment with at least two antipsychotic medications, and who receive clozapine

  • Denominator: total number of adults admitted to an inpatient setting with a primary diagnosis of schizophrenia who did not respond adequately to treatment with at least two antipsychotic medications and who were offered clozapine

  • Numerator: number of people in the denominator who receive clozapine while in hospital

  • Data source: local data collection

Failure to respond

This refers to schizophrenia that has not improved despite adequate dosages and durations of two antipsychotic medication trials, with reasonable assurance of medication adherence during the trials. The trials may or may not have been initiated within an inpatient setting.

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