The lived experience of clozapine discontinuation in patients and carers following suspected clozapine-induced neutropenia.
Clozapine
Discontinuation
Neutropenia
Journal
BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559
Informations de publication
Date de publication:
08 06 2023
08 06 2023
Historique:
received:
03
03
2023
accepted:
25
05
2023
medline:
12
6
2023
pubmed:
9
6
2023
entrez:
8
6
2023
Statut:
epublish
Résumé
Clozapine is the treatment of choice in refractory psychosis. In most countries, clozapine must be stopped indefinitely if white blood cells fall below a defined threshold during routine monitoring. Despite evidence of severe adverse consequences of clozapine discontinuation, published accounts on the lived experiences and perspectives of patients and carers are scarce. We completed semi-structured interviews with patients (n = 4) and family carers (n = 4) on experiences of clozapine cessation following suspected drug-induced neutropenia. Interviews were audio-recorded, transcribed and analysed thematically. The two overarching themes comprised:(i) stress of clozapine below threshold neutrophil results and (ii) patient and carer priorities. There is a suggested need for evidence-based pharmacological and psychological approaches to support patients and carers after clozapine cessation. Such approaches will minimise the potentially negative physical and emotional sequela in the aftermath of a below threshold neutrophil result and reduce the likelihood of experiencing additional health and social inequalities after clozapine discontinuation.
Sections du résumé
BACKGROUND
Clozapine is the treatment of choice in refractory psychosis. In most countries, clozapine must be stopped indefinitely if white blood cells fall below a defined threshold during routine monitoring. Despite evidence of severe adverse consequences of clozapine discontinuation, published accounts on the lived experiences and perspectives of patients and carers are scarce.
METHOD
We completed semi-structured interviews with patients (n = 4) and family carers (n = 4) on experiences of clozapine cessation following suspected drug-induced neutropenia. Interviews were audio-recorded, transcribed and analysed thematically.
RESULTS
The two overarching themes comprised:(i) stress of clozapine below threshold neutrophil results and (ii) patient and carer priorities.
CONCLUSIONS
There is a suggested need for evidence-based pharmacological and psychological approaches to support patients and carers after clozapine cessation. Such approaches will minimise the potentially negative physical and emotional sequela in the aftermath of a below threshold neutrophil result and reduce the likelihood of experiencing additional health and social inequalities after clozapine discontinuation.
Identifiants
pubmed: 37291505
doi: 10.1186/s12888-023-04902-w
pii: 10.1186/s12888-023-04902-w
pmc: PMC10249299
doi:
Substances chimiques
Clozapine
J60AR2IKIC
Antipsychotic Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
413Informations de copyright
© 2023. The Author(s).
Références
Psychol Med. 2020 Mar;50(4):583-594
pubmed: 30857568
Evid Based Ment Health. 2010 May;13(2):35-40
pubmed: 21856603
Psychosom Med. 2004 Mar-Apr;66(2):258-64
pubmed: 15039512
Schizophr Bull. 2022 Jan 21;48(1):176-189
pubmed: 34651184
Lancet Psychiatry. 2022 Aug;9(8):636-644
pubmed: 35772414
Mol Psychiatry. 2019 Mar;24(3):328-337
pubmed: 30647433
Schizophr Res. 2016 Jul;174(1-3):113-119
pubmed: 27211516
Epidemiol Psychiatr Sci. 2022 Nov 25;31:e83
pubmed: 36426600
Qual Health Res. 2016 Nov;26(13):1753-1760
pubmed: 26613970
BMC Psychiatry. 2021 Oct 13;21(1):502
pubmed: 34645395
Int Clin Psychopharmacol. 2019 Sep;34(5):264-268
pubmed: 30882426
Ther Adv Psychopharmacol. 2021 Sep 18;11:20451253211032053
pubmed: 34552710
Schizophr Bull. 2021 Jul 8;47(4):1088-1098
pubmed: 33543755
J Clin Psychiatry. 2017 Sep/Oct;78(8):e933-e939
pubmed: 28742291