Professional perception of clozapine use in patients with dual psychosis


  • Lara Grau-López Sección de Adicciones y Patología Dual. Servicio de Psiquiatría. Hospital Universitario Vall Hebron. Universitat Autònoma de Barcelona. CIBERSAM. Barcelona (Spain)
  • Nestor Szerman Servicio Salud Mental Retiro. Hospital Universitario Gregorio Marañón. Madrid (Spain)
  • Marta Torrens Instituto de Neuropsiquiatría y Addicciones. Hospital del Mar. IMIM-Hospital del Mar Medical Research Institut. Departamento de Psiquiatría y Medicina Legal. Universidad Autónoma de Barcelona. Barcelona (Spain)
  • Ignacio Basurte Servicio de Psiquiatría. Hospital Universitario Gregorio Marañón. Madrid (Spain)
  • Pablo Vega Sociedad Española de Patología Dual. Instituto de Adicciones. Madrid (Spain)
  • José Martínez-Raga Departamento de Psiquiatría y Psicología Médica. Hospital Universitario Doctor Peset y Universitat de Valencia. Valencia (Spain)
  • Miguel Casas Servicio de Psiquiatría. Hospital Universitario Vall Hebron. Universitat Autònoma de Barcelona. CIBERSAM. Barcelona (Spain)
  • Carlos Roncero Servicio de Psiquiatría. Complejo Asistencial Universitario de Salamanca. Instituto de Biomedicina de Salamanca. Universidad de Salamanca. Salamanca (Spain)


Antipsychotics, Dual Psychosis, Professional Perception, Schizophrenia, Alcoholism, Training


Introduction. Patients with psychotic disorders often have substance use disorders and other addictions. The objective of this study was to know the current treatment situation of these patients focusing on clozapine, which was proposed in most consensus as antipsychotic of first choice in this indication.

Material and methods. A survey with 14 questions on aspects related to the treatment and management of the dual disorders was developed, emphasizing the role of clozapine in this disease.

Results. The survey was answered by 199 experts in mental illnesses (90.5% physicians and 9.5% psychologists). A total of 88.4% of experts were able to prescribe clozapine, but the majority (89.4%) administered the drug to patients with resistant schizophrenia without considering a dual disorder. Only 30.8% considered the use of clozapine in patients with dual psychosis. The underutilization of clozapine in these patients was mainly attributed to controls of the pharmacovigilance plan, including frequent leukocyte count (57.1%), and lack of drug education (35.6%). The main measures proposed to increase its use are fewer blood tests (29.3%), more training (27.8%), and fewer administrative problems (25.1%).

Conclusions. In order to improve the treatment of patients with dual psychosis, it is necessary to simplify the therapy and increase the training of professionals in the use of atypical antipsychotics, especially clozapine, designed to be the drug of choice in the main expert consensus.



How to Cite

Grau-López, Lara, et al. “Professional Perception of Clozapine Use in Patients With Dual Psychosis”. Actas Españolas De Psiquiatría, vol. 48, no. 3, May 2020, pp. 99-105,