{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T17:12:06Z","timestamp":1792429926692,"version":"4.5.0"},"reference-count":29,"publisher":"Royal College of Psychiatrists","issue":"6","license":[{"start":{"date-parts":[[2018,1,2]],"date-time":"2018-01-02T00:00:00Z","timestamp":1514851200000},"content-version":"unspecified","delay-in-days":1858,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clozapine is the only antipsychotic drug licensed for treatment-resistant schizophrenia but its use is often delayed. Since previous studies, national guidelines on the use of clozapine and other antipsychotics have been disseminated to clinicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To determine the theoretical delay to clozapine initiation and to quantify the prior use of antipsychotic polypharmacy and high-dose antipsychotic treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Clinico-demographic data were extracted from the treatment records of all patients commencing clozapine in our centre between 2006 and 2010.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Complete records were available for 149 patients. The mean theoretical delay in initiating clozapine was 47.7 months (s.d. = 49.7). Before commencing clozapine, antipsychotic polypharmacy and high-dose treatment was evident in 36.2 and 34.2% of patients respectively. Theoretical delay was related to illness duration (\u03b2 = 0.7,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) but did not differ by gender or ethnicity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Substantial delays to clozapine initiation remain and antipsychotic polypharmacy and high doses are commonly used prior to clozapine, despite treatment guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.bp.111.105833","type":"journal-article","created":{"date-parts":[[2012,9,6]],"date-time":"2012-09-06T21:47:21Z","timestamp":1346968041000},"page":"481-485","source":"Crossref","is-referenced-by-count":324,"title":["Adherence to treatment guidelines in clinical practice: study of antipsychotic treatment prior to clozapine initiation"],"prefix":"10.1192","volume":"201","author":[{"given":"Oliver D.","family":"Howes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Vergunst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siobhan","family":"Gee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"McGuire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shitij","family":"Kapur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2018,1,2]]},"reference":[{"key":"S0007125000237082_ref27","doi-asserted-by":"publisher","DOI":"10.1177\/0269881108100320"},{"key":"S0007125000237082_ref25","doi-asserted-by":"publisher","DOI":"10.1192\/pb.bp.106.013144"},{"key":"S0007125000237082_ref24","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291701003749"},{"key":"S0007125000237082_ref23","doi-asserted-by":"publisher","DOI":"10.1192\/pb.24.12.450"},{"key":"S0007125000237082_ref21","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbp116"},{"key":"S0007125000237082_ref20","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v68n0302"},{"key":"S0007125000237082_ref19","doi-asserted-by":"publisher","DOI":"10.1097\/01.jcp.0000162798.87249.4d"},{"key":"S0007125000237082_ref18","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.161.2.361"},{"key":"S0007125000237082_ref17","doi-asserted-by":"publisher","DOI":"10.2174\/138161209788957528"},{"key":"S0007125000237082_ref16","doi-asserted-by":"publisher","DOI":"10.2165\/11587810-000000000-00000"},{"key":"S0007125000237082_ref15","volume-title":"British National Formulary (BNF59).","year":"2010"},{"key":"S0007125000237082_ref14","volume-title":"The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines.","year":"1992"},{"key":"S0007125000237082_ref13","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.09m05785yel"},{"key":"S0007125000237082_ref12","doi-asserted-by":"publisher","DOI":"10.1097\/jcp.0b013e3180d0a6d4"},{"key":"S0007125000237082_ref10","doi-asserted-by":"publisher","DOI":"10.1177\/0269881110391123"},{"key":"S0007125000237082_ref9","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1K662"},{"key":"S0007125000237082_ref8","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v64n0107"},{"key":"S0007125000237082_ref7","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbl068"},{"key":"S0007125000237082_ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-010-9398-5"},{"key":"S0007125000237082_ref3","volume-title":"Schizophrenia: Core Interventions in the Treatment and Management of Schizophrenia in Adults in Primary and Secondary Care (Updated edn). National Clinical Guideline 82.","year":"2010"},{"key":"S0007125000237082_ref1","doi-asserted-by":"publisher","DOI":"10.3371\/CSRP.4.1.4"},{"key":"S0007125000237082_fn3","unstructured":"D.T. has received consultancies fees, lecturing honoraria and\/or research funding from AstraZeneca, Janssen-Cilag, Servier, Sanofi-Aventis, Lundbeck, Bristol-Myers Squibb (BMS), Novartis, Eli Lilly and Wyeth. O.D.H. has been a speaker at meetings organised by and\/or received investigator-initiated charitable research funding from Astra-Zeneca, BMS, Eli Lilly, and Jansenn-Cilag. S.K. has received grant support from AstraZeneca and GSK, and has served as consultant and\/or speaker for AstraZeneca, Bioline, BMS-Otsuka, Eli Lilly, Janssen (J&J), Lundbeck, NeuroSearch, Pfizer, Roche, Servier and Solvay Wyeth."},{"key":"S0007125000237082_ref22","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v67n0911"},{"key":"S0007125000237082_ref26","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-993224"},{"key":"S0007125000237082_ref5","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2011.10081224"},{"key":"S0007125000237082_fn3","unstructured":"Declaration of interest"},{"key":"S0007125000237082_ref2","article-title":"Clozapine: guidelines for clinical management","volume":"50","author":"Lieberman","year":"1989","journal-title":"J Clin Psychiatry"},{"key":"S0007125000237082_ref11","volume-title":"Schizophrenia: Core Interventions in the Treatment and Management of Schizophrenia in Primary and Secondary Care (Clinical Guideline 1).","year":"2002"},{"key":"S0007125000237082_ref4","volume-title":"The Maudsley Prescribing Guidelines","author":"Taylor","year":"2010"}],"container-title":["British Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007125000237082","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,24]],"date-time":"2019-04-24T17:38:11Z","timestamp":1556127491000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007125000237082\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,12]]},"references-count":29,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2012,12]]}},"alternative-id":["S0007125000237082"],"URL":"https:\/\/doi.org\/10.1192\/bjp.bp.111.105833","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.717988632.793472713","asserted-by":"object"}]},"ISSN":["0007-1250","1472-1465"],"issn-type":[{"value":"0007-1250","type":"print"},{"value":"1472-1465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,12]]}}}