{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:00:18Z","timestamp":1792112418162,"version":"4.4.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T00:00:00Z","timestamp":1643673600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Child and Adolescent Psychopharmacology"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Schizophrenia at a young age deserves investigation because of the greater severity and burden of illness on individuals and health care than its adult onset. For this study, we included both childhood-onset schizophrenia and early-onset schizophrenia. We used the common term \u201cchildhood and adolescent-onset schizophrenia (CAOS)\u201d for either type. This systematic review provides an overview of the clinical use, efficacy, and safety of clozapine treatment in managing CAOS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We conducted a systematic literature search in PubMed, Embase, and PsycINFO databases. We searched for randomized controlled trials (RCTs), open-label studies (OLSs), review articles, meta-analytic and observational studies. Our literature search resulted in 1242 search results. After the title, abstract, and full article review, 18 studies qualified (double-blind RCTs\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20094; OLS\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20094; observational studies\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20097; case reports\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20093).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Clozapine use in CAOS was generally well tolerated and not associated with any fatalities. Clozapine use in the short term (6 weeks) and long term (2\u20139 years) was superior in efficacy than other antipsychotics in CAOS management. Improvement in overall symptoms was maintained during long-term follow-up over the years in OLSs. Clozapine appeared to have a favorable clinical response and shorter hospital stays. Sedation and hypersalivation were commonly reported (90%), constipation was next in frequency (13%\u201350%). Neutropenia was seen in 6%\u201315% of cases and agranulocytosis (&lt;0.1%). Although weight gain was common (up to 64%), followed by metabolic changes (8%\u201322%), treatment-onset diabetes was less frequent (&lt;6%). Akathisia, tachycardia, and blood pressure changes were less commonly seen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Limited studies indicate that clozapine is a safe and efficacious option for CAOS management. We need large-scale and well-designed long-term RCTs for the use of clozapine in the management of CAOS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/cap.2021.0092","type":"journal-article","created":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T10:12:51Z","timestamp":1643623971000},"page":"2-11","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":38,"title":["Clozapine for Management of Childhood and Adolescent-Onset Schizophrenia: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4608-1729","authenticated-orcid":false,"given":"Mahwish","family":"Adnan","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Motiwala","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Texas Tech University Health Science Center at Odessa\/Permian Basin Odessa, Midland, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chintan","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Texas Tech University Health Science Center at Odessa\/Permian Basin Odessa, Midland, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Sultana","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Manhattan Psychiatric Center, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeeshan","family":"Mansuri","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Boston Children's Hospital\/Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shailesh","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Texas Tech University Health Science Center at Odessa\/Permian Basin Odessa, Midland, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,2,14]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/mp.2013.59"},{"key":"e_1_3_3_3_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders 5th ed. 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