Use of clozapine in a state child and adolescent psychiatric hospital

Vanessa Bobb, Michael Weinberg, Stewart Gabel, Harvey Kranzler, Mark Olfson

Research output: Contribution to journalArticlepeer-review

Abstract

We assessed the predictors of clozapine initiation among youth 18 years and younger within a state psychiatric hospital. Administrative data (n = 358) were evaluated of inpatients from a long-term state child and adolescent psychiatric hospital. We investigated 25 background and clinical patient characteristics to determine which factors predicted clozapine initiation following the first 21 days of hospital admission. A Cox proportional model was used to evaluate factors that independently predicted the hazard rate of clozapine initiation. Emergency medication administration during the first 3 weeks of admission, which was more common among the clozapine (84.9 %) than control (61.7 %) patients (p < 0.001), was associated with a significantly increased probability of clozapine initiation (Hazard Ratio = 1.9, 95 % Confidence Interval = 1.2-3.1). Use of a mood stabilizer during the first 3 weeks of the inpatient was non-significantly related to an increased probability of clozapine initiation (Hazard Ratio = 1.7, 95 % Confidence Interval = 1.0-2.9). In this setting, emergency medication use predicts clozapine initiation suggesting that it may be used to treat patients with aggressive behavior.

Original languageEnglish
Pages (from-to)343-349
Number of pages7
JournalPsychiatric Quarterly
Volume84
Issue number3
DOIs
StatePublished - Sep 2013
Externally publishedYes

Keywords

  • Aggression
  • Clozapine
  • Inpatient
  • Pharmacology
  • Youth

ASJC Scopus subject areas

  • Psychiatry and Mental health

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