Schizophrenia Bulletinhttps://doi.org/10.1093/schbul/sbad030Clozapine Optimization:A Delphi Consensus Guideline From the TreatmentResponse and Resistance in Psychosis Working GroupElias Wagner',Dan Siskind23,Peter Falkai',Oliver Howes Christoph Correll56.78,Jimmy Lee%.10.William G.Honer.22,John M.Kane5.67,Emilio Fernandez-Egea'314,Thomas R.E.Barnes'5,Alkomiet Hasan16,andTRRIP Working Group"'Department of Psychiatry and Psychotherapy,University Hospital,LMU Munich,Munich,Germany;Department of Psychiatry,School of Medicine,University of Queensland,Brisbane,Australia;Mobile Intensive Rehabilitation Team,Metro South Addiction andMental Health Service,Brisbane,Australia;Department of Psychosis Studies,Institute of Psychiatry,Psychology and Neuroscience,King's College London,London,UK;Department of Psychiatry,The Zucker Hillside Hospital,Glen Oaks,NY USA;Institutefor Behavioral Science,Feinstein Institute for Medical Research,Manhasset,NY.USA;Departments of Psychiatry and MolecularMedicine,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell,Hempstead,NY,USA;*Department of Child andAdolescent Psychiatry,Psychosomatic Medicine and Psychotherapy,Charite Universitatsmedizin,Berlin,Germany;Department ofPsychosis,Institute of Mental Health,Singapore;Neuroscience and Mental Health,Lee Kong Chian School of Medicine,NanyangTechnological University,Singapore;"Department of Psychiatry,Institute of Mental Health,The University of British Columbia,Vancouver,Canada;British Columbia Mental Health and Substance Use Services Research Institute,Vancouver,Canada;CambridgePsychosis Centre,Cambridgeshire and Peterborough NHS Foundation Trust,Cambridge,UK;Department of Psychiatry,Universityof Cambridge,Cambridge,UK;Division of Psychiatry,Imperial College London,London,UK;Department of Psychiatry,Psychotherapy and Psychosomatics,Medical Faculty,University of Augsburg,BKH Augsburg,Augsburg,Germany"To whom correspondence should be addressed:Department of Psychiatry and Psychotherapy,LMU Munich,NussbaumstraBe 7,80336Munich,Germany;tel:0049 (0)89 4400 55505,fax:0049(0)894400 55530,e-mail:Elias.Wagner@med.uni-muenchen.deBackground and Hypothesis:There is limited evidence toavailable,this consensus-based series of recommendationsguide the approaches to clozapine treatment.Accordingly,and guidance statements supports clinical decision-makingan international initiative was undertaken with the aimto optimize clozapine monotherapy and provides guidanceof developing consensus recommendations for the optimi-for future research in treatment-resistant schizophrenia.zation of clozapine monotherapy.Study Design:We con-ducted an online Delphi survey among members of theKey words:Delphi/schizophrenia/clozapine/consensusTreatment Response and Resistance in Psychosis (TRRIP)working group comprising experts from twenty-nine coun-Introductiontries.The threshold criterion for a consensus recommenda-tion was275%agreement(“agree'”and“strongly agree'”Treatment-resistant schizophrenia(TR
