HOSPITAL DAYS IN CLOZAPINE-TREATED PATIENTS

Objective: To examine inpatient hospital days used by a group of patie nts with treatment-resistant schizophrenia for 3 years before and 3 ye ars after clozapine initiation. Method: A retrospective chart review o f 26 consecutive admissions to an outpatient clozapine clinic was cond ucted for a 6-year period. The total number of hospital days was recor ded. Results: Patients separated into 3 groups: those who used clozapi ne for 3 uninterrupted years (N = 11, 42.3%), those who interrupted bu t resumed clozapine and continued on to 3 years (N = 4, 15.4%), and th ose who abandoned clozapine treatment (N = 11, 42.3%). Only the group that was continuously on clozapine showed a decline in percentage of i npatient days during the 3-year follow-up period. Three of the IJ pati ents who discontinued clozapine died during the posttreatment period: 2 suicides and 1 ''death by misadventure.'' Conclusions: Continuous cl ozapine treatment significantly reduces days in hospital; this reducti on was sustained throughout 3 years' follow-up. While the sample size is small, all patients were tracked over a 6-year period, and both dru g continuers and dropouts were followed. The reduction in inpatient da ys may be lost if patients stop and then restart clozapine. For patien ts who do not respond to or abandon trials of clozapine, there is an u rgent need to develop more effective treatment strategies.