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Coroners warn health secretary of clozapine deaths

BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k5421 (Published 27 December 2018) Cite this as: BMJ 2018;363:k5421

Re: Coroners warn health secretary of clozapine deaths

We read with sadness of the experiences of the patients and their families described in your article 'Coroners warn health secretary of clozapine deaths'. We are however, concerned that the author does not acknowledge the experiences of the countless people who have been able to rebuild their lives through the stability that clozapine can provide.

People with schizophrenia suffer profoundly disabling and distressing psychotic symptoms, such as tormenting voices and paranoid thoughts, and face increased risks of death by suicide and through poor physical health. For many thousands of people, clozapine is the only effective drug; it alone provides relief from symptoms. Clozapine has been proven, in several large scale studies, to reduce overall mortality, compared to other antipsychotics, and compared to no treatment at all. Clozapine not only reduces the risk of suicide and self-harm, but also enables patients to better care for their physical health, and to live independent, fulfilled lives in the community. It is a serious treatment for a serious illness.

The cases described by the BMJ highlight the vital importance of careful monitoring of patients taking clozapine, and it is essential that doctors are properly trained in its safe prescription. With the appropriate care and monitoring, clozapine can be a safe and effective treatment for patients for whom all other treatment options have been exhausted.

Competing interests: No competing interests

11 January 2019
Dr. Siobhan H Gee
Principal Pharmacist
Prof. David Taylor, Dr. Fiona Gaughran, Dr. James MacCabe
South London and the Maudsley NHS Foundation Trust
Maudsley Hospital, Denmark Hill, London, SE5 8AZ