Bibliographic information
Recommendation
Clozapine should be considered for adolescents with a treatment resistant psychotic disorder (including schizophrenia) under specialist supervision, carefully balancing effectiveness, side-effects and individual preference.
Recommended in favor
Conditional
Certainty of evidence
Low
Notes and Remarks
Remarks y The medicines included in the recommendation correspond to the WHO EML (13) and are listed in alphabetical order. y Clozapine should only be offered where lab tests are available to monitor white blood cell count, and under a mental health specialist’s supervision.
Implementation considerations y Only a few antipsychotics are officially licensed for children and adolescents which should be considered in medicine choice, taking into account the country and context. y Antipsychotic medicine should be considered for adolescents with psychotic disorders only under supervision of a mental health specialist. y Adolescents are more susceptible to side-effects from antipsychotic medicines than adults. In turn, during the clinical decision-making process, adolescents living with psychosis should be made aware of benefits and side-effects so that they are able to make informed choices regarding the treatment plan. Additionally, carer preference should be taken into consideration. y Furthermore, given the higher susceptibility of adolescents to side-effects, the medicines approved in a given country should be carefully considered before formulating a treatment plan.