Clozapine for treatment-resistant schizophrenia: The case for timely and appropriate use

Position Statement PS01/26, January 2026

This position statement outlines the strong evidence supporting clozapine as the most effective treatment for individuals with treatment-resistant schizophrenia (TRS) and the only antipsychotic recommended by evidence-based national guidelines for this condition.

It highlights that early initiation of clozapine after a TRS diagnosis is associated with better clinical outcomes, but that, despite this, clozapine remains underprescribed and is often started later than recommended, potentially limiting its benefits. 

This document sets out practical, clinical and system-level strategies to support the appropriate and timely use of clozapine in patients with TRS, with the aim of improving clinical outcomes and reducing avoidable delays in care.

It discusses clinician-, patient- and service-level barriers that contribute to delays in the appropriate use of clozapine.

Wim’s Protocol: for the safe prescribing and monitoring of clozapine

We've published a practical guide to help with the prescribing of clozapine, which also contains information for family, friends, support workers and others interested in patients’ welfare.
Find out more about the protocol