Section - Quick Takes

02. In the Aftermath of Clozapine Discontinuation: Comparative Effectiveness and Safety of Antipsychotics in Patients With Schizophrenia Who Discontinue Clozapine

Published on September 1, 2020 Expired on April 1, 2023

James Phelps, M.D.

Research Editor - Psychopharmacology Institute

Key Points

In patients who have stopped clozapine after staying on it for a year or more, restarting clozapine itself is perhaps the best option.

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What should you do when patients have been on clozapine for over a year, and the next time you see them, they are not taking it? Should you restart it or move on? You would ask why did they stop it––did not work out well, side effects, or did not want to take such medication anymore? Another way to determine what might work best is to look at the experience of thousands of patients in that circumstance and find which choices were associated with the best outcomes.

In this Quick Take, we will look at a recent study using the Finnish National Registry. The authors looked at all persons with a schizophrenia diagnosis from 1972 to 2014 who started clozapine. Interestingly, they found that 50% of them discontinued it within a year. Then, they took the other half, 2200 patients, who continued for more than a year and then stopped

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03. Efficacy and Safety of Lumateperone for Treatment of Schizophrenia

Learning Objectives:

After completing this activity, the learner will be able to:

Evaluate the evidence implicating oral contraceptives in altered HPA axis physiology and consider the clinical implications thereof.
Evaluate the outcomes in patients who have stopped taking clozapine after taking it for a year or more, comparing the restarting of clozapine vs some other antipsychotic vs no antipsychotic at all.
Compare the data presented in a new study of lumateperone with the balanced view of an accompanying editorial.
Compare their clinical experience with lithium to new data in terms of both the impact of stopping the drug (measured by hospitalization rate) and the rate at which patients stop it due to various side effects.
Evaluate a recent network meta-analysis (with a reminder on how NMAs work) regarding optimal treatment for adult depression: Should you start with psychotherapy, pharmacotherapy, or both?

Original Release Date: September 1, 2020

Review and Re-release Date: March 1, 2023

Expiration Date: April 1, 2023

Relevant Financial Disclosures:

James Phelps declares the following interests:

- McGraw-Hill: book on bipolar disorder

- W.W. Norton & Co.: book on bipolar disorder

All of the relevant financial relationships listed above have been mitigated by Medical Academy and the Psychopharmacology Institute.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

Instructions for Participation and Credit:

Participants must complete the activity online during the valid credit period that is noted above.

Follow these steps to earn CME credit:

View the required educational content provided on this course page.
Answer the quiz for promoting retention of knowledge.
Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
Download your certificate.

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.