The lived experience of clozapine discontinuation in patients and carers following suspected clozapine-induced neutropenia

BMC Psychiatry

Research

Danielle Dunnett¹  James H MacCabe²  Juliana Onwumere³  Ebenezer Oloyede⁴  David Taylor⁵  Ivana Clark⁵  Eromona Whiskey⁶ 

[1]Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, King’s College London, London, UK

[2]Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, King’s College London, London, UK

[3]National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK

[4]NIHR Biomedical Research Centre for Mental Health South London and Maudsley NHS, London, UK

[5]National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK

[6]NIHR Biomedical Research Centre for Mental Health South London and Maudsley NHS, London, UK

[7]Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK

[8]Pharmacy Department, South London and Maudsley NHS Foundation Trust, London, UK

[9]Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, King’s College London, London, UK

[10]University of Oxford, Department of Psychiatry, Warneford, United Kingdom

[11]Pharmacy Department, South London and Maudsley NHS Foundation Trust, London, UK

[12]Institute of Pharmaceutical Science, King’s College, London 5th Floor, Franklin-Wilkins Building 150 Stamford Street, SE1 9NH, London, UK

[13]Pharmacy Department, South London and Maudsley NHS Foundation Trust, London, UK

[14]Institute of Pharmaceutical Science, King’s College, London 5th Floor, Franklin-Wilkins Building 150 Stamford Street, SE1 9NH, London, UK

[15]National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK

关键词: Clozapine;    Discontinuation;    Neutropenia;   

DOI  :  10.1186/s12888-023-04902-w

 received in 2023-03-03, accepted in 2023-05-25,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundClozapine 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.MethodWe 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.ResultsThe two overarching themes comprised:(i) stress of clozapine below threshold neutrophil results and (ii) patient and carer priorities.ConclusionsThere 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.

【 授权许可】

CC BY   
© The Author(s) 2023