TY - JOUR
T1 - Effectiveness of Clozapine on Employment Outcomes in Treatment-Resistant Schizophrenia
T2 - A Retrospective Bidirectional Mirror-Image Study
AU - Matsuzaki, Haruna
AU - Hatano, Masakazu
AU - Iwata, Miko
AU - Saito, Takeo
AU - Yamada, Shigeki
N1 - Funding Information:
This work was supported by TAIHO PHARMACEUTICAL for English editing and publication of the article through a scholarship donation. This study also received funding from TAIHO PHARMACEUTICAL through a scholarship donation. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication.
Publisher Copyright:
© 2023 Matsuzaki et al.
PY - 2023
Y1 - 2023
N2 - Purpose: Clozapine is more effective than other antipsychotics and is the only antipsychotic approved for treatment-resistant schizophrenia. The objective of this study is to reveal the effect of clozapine on employment using a bidirectional mirror-image model. Patients and Methods: This design was a retrospective observational study that investigated the employment status of patients with treatment-resistant schizophrenia based on medical records. The bidirectional mirror-image model consisted of 1) switching from other antipsychotics to clozapine and 2) switching from clozapine to other antipsychotics. The observation period was 1 year for each pre-and post-clozapine initiation and discontinuation. Results: We included 36 patients in the bidirectional mirror-image model. The regular employment plus employment support rate was significantly higher in the clozapine phase than in the other antipsychotic phase in the bidirectional mirror-image model (30.6% vs 11.1%, P = 0.039). The days of regular employment plus employment support were also significantly longer in the clozapine phase (61.3 ± 106.2 vs 24.7 ± 82.7 days, P = 0.032). As per the unidirectional mirror-image model, switching to clozapine resulted in significantly higher regular employment plus employment support rates in the clozapine phase than those in the other antipsychotic phase (33.3% vs 10.0%, P = 0.039). Switching from clozapine to other antipsychotics did not exhibit significant differences in any outcomes. Conclusion: The results suggest that clozapine is superior to other antipsychotics with respect to achieving employment in patients with treatment-resistant schizophrenia. However, biases specific to the mirror-image model need to be considered.
AB - Purpose: Clozapine is more effective than other antipsychotics and is the only antipsychotic approved for treatment-resistant schizophrenia. The objective of this study is to reveal the effect of clozapine on employment using a bidirectional mirror-image model. Patients and Methods: This design was a retrospective observational study that investigated the employment status of patients with treatment-resistant schizophrenia based on medical records. The bidirectional mirror-image model consisted of 1) switching from other antipsychotics to clozapine and 2) switching from clozapine to other antipsychotics. The observation period was 1 year for each pre-and post-clozapine initiation and discontinuation. Results: We included 36 patients in the bidirectional mirror-image model. The regular employment plus employment support rate was significantly higher in the clozapine phase than in the other antipsychotic phase in the bidirectional mirror-image model (30.6% vs 11.1%, P = 0.039). The days of regular employment plus employment support were also significantly longer in the clozapine phase (61.3 ± 106.2 vs 24.7 ± 82.7 days, P = 0.032). As per the unidirectional mirror-image model, switching to clozapine resulted in significantly higher regular employment plus employment support rates in the clozapine phase than those in the other antipsychotic phase (33.3% vs 10.0%, P = 0.039). Switching from clozapine to other antipsychotics did not exhibit significant differences in any outcomes. Conclusion: The results suggest that clozapine is superior to other antipsychotics with respect to achieving employment in patients with treatment-resistant schizophrenia. However, biases specific to the mirror-image model need to be considered.
UR - http://www.scopus.com/inward/record.url?scp=85150818631&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85150818631&partnerID=8YFLogxK
U2 - 10.2147/NDT.S402945
DO - 10.2147/NDT.S402945
M3 - Article
AN - SCOPUS:85150818631
SN - 1176-6328
VL - 19
SP - 615
EP - 622
JO - Neuropsychiatric Disease and Treatment
JF - Neuropsychiatric Disease and Treatment
ER -