Clozapine safety monitoring and related research in psychiatry and neurology in South America: A scoping review

Schizophr Res. 2023 Aug 2:S0920-9964(23)00255-4. doi: 10.1016/j.schres.2023.07.029. Online ahead of print.

Abstract

The quality and quantity of clozapine safety monitoring considerably differs among South American countries and mainly focus on hematological surveillance. Few studies have been conducted on other clozapine-related adverse effects (ADRs) and mainly refer to case reports and literature reviews. We retrieved thirty-nine publications on clozapine related ADRs others than neutropenia. Studies in Brazil and Venezuela accounted for 67 % of all the publications, and 8 out of 12 countries published 2 or less manuscripts. Only Chile offers serum clozapine level measurement in public institutions. Given the recently recognized role of ethnicity, gender, smoking, obesity drug interactions in optimal clozapine administration, modernization of clozapine clinical use and research in psychiatry and neurology most be broadcasted and stimulated in South American countries.

Keywords: Clozapine availability; Ethnicity; Movement disorders; Off-labelled use; Schizophrenia; Side effect monitoring.