A Retrospective Review of the Use of Clozapine in Restoration of Competency to Stand Trial

Article Figures & Data

Table 1.

Sociodemographic, Clinical, and Legal Characteristics by Clozapine Use

Characteristic	Clozapine Group	No Clozapine Group	P
Age, years^{^a}	32.4 (10.0)	37.5 (18.0)	.044
Time to opinion, days^{^a}	202.0 (129)	147.0 (89.0)	<. 001
Length of stay, days^{^a}	343.0 (333.0)	178.0 (137.0)	< .001
Male	22 (88.0)	170 (79.1)	.429
Race			.686
Non-Hispanic white	12 (48.0)	121 (56.3)
Non-Hispanic black	13 (52.1)	84 (39.1)
Main psychiatric discharge diagnosis			.748
Schizophrenia spectrum and other psychotic disorders	23 (92.0)	188 (87.4)
Bipolar and related disorders	2 (8.0)	27 (12.6)
Competency			< .001
Competent to stand trial	8 (32.0)	187 (87.0)
Permanently incompetent to stand trial	17 (68.0)	28 (13.0)
Charges type			.651
Felony	17 (70.8)	128 (59.5)
Misdemeanor	3 (12.5)	35 (16.3)
Both	4 (16.7)	52 (24.2)
Prior psychiatric treatment	22 (88.0)	199 (92.6)	.429
Antipsychotic use through stay
Formulation			.913
Oral	15 (60.0)	130 (60.5)
Long-acting injectable ± oral	10 (40.0)	79 (36.7)
Class			.223
Atypical only	10 (40.0)	100 (46.5)
Typical and atypical	15 (60.0)	89 (41.4)
Number of antipsychotics through stay			.009
One	1 (4.0)	61 (28.4)
Two or more	24 (96.0)	147 (68.4)
Psychiatric medications upon discharge
Antipsychotics	24 (96.0)	172 (80.0)	.056
Mood stabilizers	9 (36.0)	55 (25.6)	.338
Antidepressants	5 (20.0)	60 (27.9)	.483

↵a Data presented as median (interquartile range).
All other data are presented as n (%). P values in bold indicate statistical significance: p < 0.05. Clozapine Group: n = 25; No Clozapine Group: n = 215.

Table 2.

Sociodemographic, Clinical, and Legal Characteristics of the Clozapine Group by Outcome of Competency Restoration

Characteristic	Competent to Stand Trial	Permanently Incompetent to Stand Trial	P
Age, years^{^a}	36.2 (7.3)	28.9 (10.3)	.315
Time to opinion, days^{^a}	183.0 (83.0)	225.0 (166.0)	< .001
Length of stay, days^{^a}	214.0 (77.5)	415.0 (324.0)	.063
Maximum clozapine dose prior to opinion^{^a}	475.0 (275.0)	400.0 (462.5)	.892
Clozapine dose at blood draw^{^a}	375.0 (250.0)	450.0 (300.0)	.314
Last clozapine level prior to opinion^{^a}	397.0 (141.0)	473.0 (431.0)	.209
Last norclozapine level prior to opinion^{^a}	158.0 (43.0)	293.0 (105.0)	.010
Clozapine dose upon discharge^{^a}	425.0 (206.3)	500.0 (250.0)	.593
Male	7 (87.5)	15 (88.2)	1.000
Race			1.000
Non-Hispanic white	4 (50.0)	8 (47.1)
Non-Hispanic black	4 (50.0)	9 (52.9)
Main psychiatric discharge diagnosis			1.000
Schizophrenia spectrum and other psychotic disorders	7 (87.5)	16 (94.1)
Bipolar and related disorders	1 (12.5)	1 (5.9)
Charges type			.339
Felony	7 (87.5)	10 (62.5)
Misdemeanor	1 (12.5)	2 (12.5)
Both	0 (0.0)	4 (25.0)
Prior psychiatric treatment	5 (62.5)	17 (100.0)	.024
Antipsychotic use through stay
Formulation			1.000
Oral	5 (62.5)	10 (58.8)
Long-acting injectable ± oral	3 (37.5)	7 (41.2)
Class			.667
Atypical	4 (50.0)	6 (35.3)
Typical and atypical	4 (50.0)	11 (64.7)
Number of antipsychotics through stay			.320
One	1 (12.5)	0 (0.0)
Two or more	7 (87.5)	17 (100.0)
Psychiatric medications upon discharge
Clozapine	8 (100.0)	7 (41.2)	.008
Antipsychotics	8 (100.0)	16 (94.1)	1.000
Mood stabilizers	3 (37.5)	6 (35.3)	1.000
Antidepressants	1 (12.5)	4 (23.5)	1.000

↵a Data presented as median (interquartile range).
All other data are presented as n (%). Competent to Stand Trial Group: n = 8; Permanently Incompetent to Stand Trial Group: n = 17.