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dc.contributor.authorRose, Emilyen
dc.contributor.authorChen, Shanquanen
dc.contributor.authorTurrion, Conchaen
dc.contributor.authorJenkins, Christopheren
dc.contributor.authorCardinal, Rudolfen
dc.contributor.authorFernandez-Egea, Emilioen
dc.date.accessioned2020-05-26T23:31:37Z
dc.date.available2020-05-26T23:31:37Z
dc.date.issued2020-07en
dc.identifier.issn0924-977X
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/305798
dc.description.abstractUncertainty regarding the excess of mortality in patients treated with clozapine persists. A decrease in all-cause mortality, and perhaps also in suicide, after clozapine initiation has been reported, but there are no studies in which preventable causes were ascertained in those taking medication in the long term. Here, we aimed to assess a decade of causes of deaths in a catchment area in patients with schizophrenia chronically treated with clozapine and compared them to a clozapine-treated control cohort. Causes of deaths were classified as suicide, expected (e.g. cancer), and unexpected deaths (encompassing causes of death potentially due to clozapine side effects, and unexplained sudden death). We used descriptive statistics for comparing socio-demographic and clinical factors between the three groups. Logistic regression models were used to examine risk factors associated with unexpected death compared to the control group. We found that the overall mortality was similar to that in previous studies (at 0.8% yearly on average) with unexpected deaths accounted for 52% of total deaths. The unexpected deaths group was on average treated with higher clozapine doses (mean 460 mg/day). A small but significant peak of unexpected deaths was found during the 2018 summer heat wave, which might have exacerbated dose-dependent side effects of clozapine. We recommend an increased monitoring for those on higher doses of clozapine is suggested as one potential intervention to decrease mortality in this population.
dc.description.sponsorshipThis work is not directly funded by any organization. The work uses information for the CPFT Research Database, which was supported by the UK National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre (BRC); the views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. SC’s and RNC’s research was supported by the Medical Research Council (grant MC_PC_17213 to RNC).
dc.format.mediumPrint-Electronicen
dc.languageengen
dc.publisherElsevier
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectHumansen
dc.subjectClozapineen
dc.subjectAntipsychotic Agentsen
dc.subjectCause of Deathen
dc.subjectCase-Control Studiesen
dc.subjectRetrospective Studiesen
dc.subjectCohort Studiesen
dc.subjectSuicideen
dc.subjectSchizophreniaen
dc.subjectAdulten
dc.subjectAgeden
dc.subjectMiddle Ageden
dc.subjectNational Health Programsen
dc.subjectEnglanden
dc.subjectFemaleen
dc.subjectMaleen
dc.subjectCatchment Area, Healthen
dc.titleCauses of death in clozapine-treated patients in a catchment area: a 10-year retrospective case-control study.en
dc.typeArticle
prism.endingPage166
prism.publicationDate2020en
prism.publicationNameEuropean neuropsychopharmacology : the journal of the European College of Neuropsychopharmacologyen
prism.startingPage160
prism.volume36en
dc.identifier.doi10.17863/CAM.52877
dcterms.dateAccepted2020-05-24en
rioxxterms.versionofrecord10.1016/j.euroneuro.2020.05.011en
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2020-07en
dc.contributor.orcidChen, Shanquan [0000-0002-4724-4892]
dc.contributor.orcidCardinal, Rudolf [0000-0002-8751-5167]
dc.identifier.eissn1873-7862
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idMRC (MC_PC_17213)
cam.orpheus.successMon Jun 22 08:17:19 BST 2020 - Embargo updated*
cam.orpheus.counter3*
rioxxterms.freetoread.startdate2021-06-13


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Attribution-NonCommercial-NoDerivatives 4.0 International
Except where otherwise noted, this item's licence is described as Attribution-NonCommercial-NoDerivatives 4.0 International