- Clozapine is the most effective treatment for treatment-resistant schizophrenia yet underused due to safety concerns and preventable adverse outcomes.
- Evidence on clozapine safety is fragmented and methodologically heterogeneous, limiting translation into clinical practice.
- Integrating pharmacovigilance, therapeutic drug monitoring, pharmacokinetics and pharmacogenetics into a coherent clinical framework could improve risk prediction and individualisation.
BJPsych Bull. 2026 Sep 17:1-3. doi: 10.1192/bjb.2026.10284. Online ahead of print.
ABSTRACT
Clozapine remains the most effective treatment for treatment-resistant schizophrenia, yet its use is constrained by concerns about safety and preventable adverse outcomes. Evidence on clozapine safety remains fragmented and methodologically heterogeneous, limiting translation into clinical practice. Pharmacovigilance, therapeutic drug monitoring, pharmacokinetics and pharmacogenetics provide complementary information that is rarely considered together. This editorial argues that integrating these approaches within a coherent clinical framework may improve prediction and individualisation of risk while acknowledging current methodological limitations. Progress may therefore depend less on generating additional isolated evidence than on connecting the data already available.
PMID:42750379 | DOI:10.1192/bjb.2026.10284
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