Yasutaka Ojio, Takuma Shiozawa, Ernesto R Gregorio, Maria Cynthia Leynes, Paul Michael R Hernandez, Crystal Amiel M Estrada, Taruto Fuyama, Jun Kobayashi, Naoko Satake
An international interdisciplinary approach to developing video educational materials promoting mental health literacy among adolescents in the Philippines
Early intervention in psychiatry
agranulocytosis lifethreatening sideeffect clozapine approved drug treatmentresistant schizophrenia longterm profile complication yet well established aim describe risk clozapineinduced agranulocytosis long term used entire population finland identify people diagnosed schizophrenia schizoaffective disorder 1972 2014 developed kaplanmeier model time diagnosis agranulocytosis clozapine versus nonclozapine treatment 22year observation period 1996 2017 next developed nested casecontrol model agranulocytosis matching sex age time since diagnosis incident cohort 1 5 ratio various durations use clozapine nonclozapine antipsychotic treatment compared modal antipsychotic use duration deriving adjusted odds ratios aors multivariable regression model recurrence lethality rates clozapineinduced agranulocytosis described data reflect individuals lived experience schizophrenia finland study time although individuals lived experience included design study identified 61 769 people schizophrenia schizoaffective disorder 14 037 individuals treated clozapine 47 732 individuals treated nonclozapine antipsychotics mean age 4667 years iqr 34445761 30 721 497 female 31 048 503 male data ethnicity available among 398 individuals diagnosed agranulocytosis 231 individuals treated clozapine 167 individuals treated nonclozapine antipsychotics representing cumulative incidence agranulocytosis 137 95 ci 058316 clozapine 013 004023 nonclozapine antipsychotics case n398 versus control n1987 model risk clozapineinduced agranulocytosis decreased steeply time aor 3601 95 ci 16797722 less 6 months clozapine 438 1861034 clozapine use 54 months one 3559 individuals starting clozapine died clozapineinduced agranulocytosis risk clozapineinduced agranulocytosis decreases steeply time might persistently greater nonclozapine antipsychotics longterm risk excess seems small absolute terms compared known magnitude advantages clozapine relevant outcomes including life expectancy given widespread underuse clozapine relaxing longterm neutrophil monitoring could favour advantages longterm clozapine use including greater life expectancy without incurring intolerable risk clozapineinduced agranulocytosis northwell health sigrid juslius foundation