Improving Adherence and Outcomes in Early Onset Schizophrenia: A Case Series on Role of Clozapine and Long-Acting Injectables for Refractory Courses
Abstract
Early onset schizophrenia (EOS) is a rare and severe psychiatric disorder associated with marked functional impairment and a complex diagnostic trajectory. Comorbid anxiety, mood dysregulation, and substance use further complicate clinical presentation and contribute to a more refractory course. Clozapine is widely acknowledged as the most efficacious treatment for individuals unresponsive to conventional antipsychotic therapy. However, its use in adolescents remains limited despite strong evidence of substantial clinical benefits, given the insidious and pernicious nature of this disorder. Although formal trials in adolescents are limited, observational data and clinical practice suggest that this combined approach may offer meaningful advantages for youth with persistent psychosis. This case series describes six adolescents between 15 and 17 years of age who presented with severe psychotic symptoms, recurrent aggression, suicidality, or significant functional decline despite multiple adequate trials of oral antipsychotic medications. Clozapine was initiated in each case, and four patients also received a long-acting injectable antipsychotic (LAI) after establishing oral tolerability. Across cases, clozapine alone or in combination with an LAI was associated with substantial improvement in positive symptoms, behavioral regulation, and overall clinical stability, allowing transition to the least restrictive settings. These findings illustrate the potential usefulness of…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Tryptophan Metabolism and Gut-Brain Homeostasis
- Rationale for a Multi-Factorial Approach for the Reversal of Cognitive Decline in Alzheimer’s Disease and MCI: A Review
- Prioritized Research for the Prevention, Treatment, and Reversal of Chronic Disease: Recommendations From the Lifestyle Medicine Research Summit
- Relationship between sleep disorders and gut dysbiosis: what affects what?
- The role of CLOCK gene in psychiatric disorders: Evidence from human and animal research
- Genetic, Transcriptome, Proteomic, and Epidemiological Evidence for Blood-Brain Barrier Disruption and Polymicrobial Brain Invasion as Determinant Factors in Alzheimer’s Disease
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.