Determinants of patient satisfaction in clozapine users: results from the Clozapine International Consortium (CLOZIN)

• DOI: 10.1038/s41537-025-00570-9
• Publication Date: 2025-02-23T13:07:16Z
• Authors: Marte Z. van der ...; Nini de Boer; ; Ahmet Müderrisoğlu; Alba Toll Privat; Alde Bouhuis; Alkomiet Hasan; Amy Jongkind; Ana Gonzalez-Pinto; Anna Mane Santacana; Armando D’Agostino; Aygün Ertuğrul; A. Elif Anıl Yağc...; Benedicto Crespo-...; Bernhard T. Baune; Bianca Sanchez-Ba...; Carlos Spuch; Carla Lou Morgenroth; Carmen Fernandez ...; Cecilia Casetta; Chad Bousman; Christa Hohoff; Christos Pantelis; Claudia Ovejas-Ca...; Clemente Garcia-Rizo; Dan Cohen; Dragana Ignjatovi...; Edwin Beld; Eila Repo-Tiihonen; Elias Wagner; Ellen Jeger-Land; Elisabet Vilella; Emilio Fernandez-...; Erwin Bekema; Esteban Sepúlveda; Federico Wiedenmann; Francesca Martini; Francesca Serio; Francesca Vairano; Giacomo Mercuriali; Giovanni Boido; Gökhan Yoca; Hanneke van Beek; Harm Gijsman; Heli Tuppurainen; Ian Everall; Ivona Novakovic; Inaki Zorrilla; İ. Mert Erdoğan; Jacopo Sapienza; Jan Bogers; Jari Tiihonen; Javier Vázquez-Bo...; Jim van Os; Johannes Schneide...; Jurjen Luykx; Koen Grootens; Lorea Mar-Barrutia; Lourdes Martorell; Maarten Bak; Marco Spangaro; Marco Zierhut; Marije de Vos; Mariken de Koning; Marina Garriga; Markku Lähteenvuo; Marta Bosia; Marte van der Horst; Melih O. Babaoğlu; Mike Veereschild; Mirko Manchia; Mishal Qubad; Monika Edlinger; Paloma Fuentes-Pérez; Pasquale Paribello; Purificacion Lope...; René Kahn; Robert A. Bittner; Roberto Cavallaro; Selene Veerman; Stefan Gutwinski; Stefanie Schreiter; Stephan Ripke; Tania Rivera Balt...; Tatiana Oviedo-Sa...; Tero Hallikainen; Thomas Görlitz; Wouter Alink; Yavuz Ayhan; Cynthia Okhuijsen...; Jurjen J. Luykx
• Keywords: Psychiatry; ddc:610; INDUCED HYPERSALIVATION; MEDICATIONS; RC435-571; VIEWS; ASSOCIATION; SCHIZOPHRENIA-PATIENTS; ddc:

Abstract Clozapine is highly effective for treatment-resistant schizophrenia but is underutilized due to patient and clinician-related concerns. Little is known about the general level of patient satisfaction with clozapine and determinants thereof. We therefore explored determinants of patient satisfaction with clozapine in individuals diagnosed with schizophrenia spectrum disorders (SSDs). Cross-sectional data from 480 clozapine users were used to examine demographic and clinical factors, including symptom severity, treatment response, and adverse drug reactions (ADRs). Patient satisfaction was self-rated on a scale of 1 to 10. Results showed a mean satisfaction score of 7.4 (SD = 1.9), with significant associations between satisfaction and treatment response (B = 0.42, R² = 0.19, p = 3.9 × 10⁻¹⁸), symptom severity (B = 0.10, R² = 0.05, p = 2.06 × 10-9), occurrence of ADRs (B = −0.16, R² = 0.06, p = 3.2 × 10-5), and recreational drug use (B = −1.32, R² = 0.05, p = 2.09 × 10-4). Hypersalivation and prolonged sleep duration were the only ADRs linked to lower satisfaction (B = −0.72, R² = 0.06, p = 3.5 × 10-5 and B = −0.57, R² = 0.04, p = 1.4 × 10-3, respectively). Despite concerns about ADRs, treatment effectiveness showed a stronger association with patient satisfaction among clozapine users than the occurrence of ADRs. In conclusion, our findings suggest that strategies aimed at bolstering clozapine’s effectiveness may help counter worldwide underprescription rates of clozapine in patients with SSDs.