Results of a study published Monday in The Lancet suggest the schizophrenia drug clozapine is associated with a “substantially lower” mortality in patients who take the product, compared with those who take other antipsychotics, researchers noted. Study leader Jari Tiihonen commented: “In all western countries, clozapine is recommended for use only as a second-line drug. I would like to see it considered for first-line use.”

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The study examined death rates in Finland between 1996 and 2006 in the general population versus those of about 67000 patients with schizophrenia who were taking the six most frequently prescribed antipsychotic drugs. Results showed that compared to patients treated with perphenazine, those who took clozapine had a 26-percent reduction in mortality, representing the lowest risk in the analysis. In addition, data showed that the highest increase in risk was observed in patients who took AstraZeneca’s Seroquel (quetiapine), who had a 41-percent increase in mortality compared with those who took perphenazine.

Patients taking clozapine, which is sold by Novartis as Clozaril and is also available as a generic, require regular blood tests for agranulocytosis. The researchers said that the difference in mortality seen in the study between clozapine and the other antipsychotic drugs may be attributable to more intensive monitoring during treatment with clozapine, greater effectiveness of clozapine, lower safety of other drugs, or all of these factors.

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Professor Tim Kendall, deputy director of the Royal College of Psychiatrist’s research unit, who was not involved in the study, stated: “These findings should be interpreted with real caution. The evidence for first-line use is not there. Clozapine is associated with a much broader range of side effects.”

Source: FirstWord

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