{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T08:09:58Z","timestamp":1789200598156,"version":"build-2803163510"},"reference-count":79,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"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":["J Psychopharmacol"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Clozapine (CLZ) stands out for its unique receptor profile, making it more effective than other antipsychotics, especially in treatment-resistant schizophrenia (TRS). There is growing evidence supporting its use in schizoaffective disorder (SZD), although diagnostic challenges and drug characteristics have complicated the implementation of specific clinical trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>Compare efficacy and tolerability of CLZ in real-world patients with TRS and SZD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Prospective, pragmatic, three-month, evaluator-blinded clinical trial with two randomised controlled arms (TRS groups) and a third fixed arm (SZD group). The clinical response was assessed by monthly visits during which the Positive and Negative Syndrome Scale (PANSS), Young Mania Rating Scale (YMRS), Montgomery\u2013Asberg Depression Rating Scale (MADRS), Calgary Depression Scale for Schizophrenia (CDSS), Clinical Global Impression (CGI) and Udvalg f\u00fcr Kliniske Undersogelser were administered. One hundred twenty-seven participants (74.8% men, 25.2% women; 84 TRS, 42 SZD; mean age of 38.53) completed the follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Patients treated with CLZ showed a greater reduction in all the PANSS subscales, MADRS and CDSS. In cases of SZD, there was a significant decrease in positive (\n                      <jats:italic toggle=\"yes\">F<\/jats:italic>\n                      : 3.72,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05) and negative (\n                      <jats:italic toggle=\"yes\">F<\/jats:italic>\n                      : 6.58,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01) symptoms, the overall score of PANSS (\n                      <jats:italic toggle=\"yes\">F<\/jats:italic>\n                      : 5.64,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and YMRS (\n                      <jats:italic toggle=\"yes\">F<\/jats:italic>\n                      : 12.01,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Patients using CLZ had a better subjective perception of their treatment (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      : 17.29,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01). CLZ prescription was the only predictor of better outcomes across all the scales and improved substance use (dual disorders).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>CLZ was effective in reducing psychotic and affective symptoms in patients with dual psychosis, with better outcomes in SZD compared with TRS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>EudraCT protocol trial:<\/jats:title>\n                    <jats:p>\n                      2021-001278-44 (Comparative analysis of the effectiveness of clozapine in resistant schizophrenia and schizoaffective disorder;\n                      <jats:italic toggle=\"yes\">clinicaltrialsregister.eu\/ctr-search\/trial\/2021-001278-44\/ES<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02698811251355602","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T07:17:31Z","timestamp":1754032651000},"page":"1284-1298","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Randomised controlled trial of clozapine in resistant schizophrenia and schizoaffective disorder"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7860-765X","authenticated-orcid":false,"given":"Marc","family":"Peraire","sequence":"first","affiliation":[{"name":"TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, Castell\u00f3 de la Plana, Spain"},{"name":"Department of Mental Health, Consorci Hospitalari Provincial de Castell\u00f3, Castell\u00f3 de la Plana, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5820-1647","authenticated-orcid":false,"given":"Francisco","family":"Arnau-Peir\u00f3","sequence":"additional","affiliation":[{"name":"TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, Castell\u00f3 de la Plana, Spain"},{"name":"Department of Mental Health, Consorci Hospitalari Provincial de Castell\u00f3, Castell\u00f3 de la Plana, Spain"},{"name":"Pre-Departmental Medicine Unit, Universitat Jaime I, Castell\u00f3 de la Plana, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2052-5045","authenticated-orcid":false,"given":"Mariano","family":"Villar-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Department of Mental Health, Consorci Hospitalari Provincial de Castell\u00f3, Castell\u00f3 de la Plana, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0785-3570","authenticated-orcid":false,"given":"Ana","family":"Benito","sequence":"additional","affiliation":[{"name":"TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, Castell\u00f3 de la Plana, Spain"},{"name":"Torrent Mental Health Unit, Hospital General Universitario de Valencia, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2155-9543","authenticated-orcid":false,"given":"Iv\u00e1n","family":"Echeverria","sequence":"additional","affiliation":[{"name":"TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, Castell\u00f3 de la Plana, Spain"},{"name":"Department of Mental Health, Consorci Hospitalari Provincial de Castell\u00f3, Castell\u00f3 de la Plana, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1299-9611","authenticated-orcid":false,"given":"Gonzalo","family":"Haro","sequence":"additional","affiliation":[{"name":"TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, Castell\u00f3 de la Plana, Spain"},{"name":"Department of Mental Health, Consorci Hospitalari Provincial de Castell\u00f3, Castell\u00f3 de la Plana, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-023-01560-7"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0920-9964(90)90005-R"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.09m05785yel"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2017.02.005"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12742"},{"key":"e_1_3_2_7_1","unstructured":"Baethge C (2003) Long-term treatment of schizoaffective disorder: Review and recommendations. 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