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Usage of clozapine and the new neuroleptics

A postal questionnaire survey among general psychiatrists

Cheam Resource Centre, 671 London Road, North Cheam SM3 9DL

Aims and method To explore clozapine and atypical antipsychotic usage in England and Wales, particularly availability, restrictions on use and shifting of prescribing to general practitioners. To examine the hypothesis that respondents in acute trusts would encounter more restrictions. Method used — postal questionnaire sent to general psychiatrists derived from the 1996 Medical Directory.

Results There was an 80% response rate and over 90% of respondents used clozapine, with only 9% reporting any difficulty in obtaining it. Difficulty was not associated with any particular type of trust. Only about 4% of respondents suggested that general practitioners regularly took over the prescribing costs of the drug.

Clinical implications Optimistic, with widespread usage and few difficulties in obtaining clozapine. General practitioner prescribing is still very low and needs to increase.