TOPLINE:

A real-world trial showed that in adults with dual psychosis, clozapine was effective in alleviating psychotic and affective symptoms, with better outcomes being observed in schizoaffective disorder (SZD) than in treatment-resistant schizophrenia (TRS).

METHODOLOGY:

Researchers conducted a prospective, pragmatic clinical trial from 2021 to 2024 in Spain and included 127 participants with refractory psychosis (mean age, 38.5 years; 74.8% men).

Participants were divided into three arms: those with TRS receiving clozapine (TRS-clozapine; n = 43), those with TRS receiving optimised standard antipsychotics (TRS-control; n = 42), and those with SZD receiving clozapine (SZD-clozapine; n = 42; non-randomised due to low prevalence).

Monthly assessments over 3 months included the

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