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Randomized, controlled trials (RCTs) of atypical antipsychotics generally do not include patients with treatment-resistant schizophrenia (TRS; defined as failure to respond to 2 antipsychotics). To assess the role of clozapine in a less-selected population, researchers conducted a meta-analysis of 63 nonrandomized cohort studies involving 109,341 patients (mean age, 39; mean duration of illness, 11 years) treated with clozapine or another atypical. Fourteen studies included patients with treatment-resistant disease.
Despite clozapine recipients being more severely ill than patients receiving other atypicals and despite the monitoring required with this drug, it significantly reduced the risks for hospitalization by 18% (number needed to trea…