Clin Psychopharmacol Neurosci.  2016 Nov;14(4):323-329. 10.9758/cpn.2016.14.4.323.

Clozapine Monitoring in Clinical Practice: Beyond the Mandatory Requirement

Affiliations
  • 1Black Country Partnership NHS Foundation Trust, Wolverhampton, United Kingdom. kar.nilamadhab@yahoo.com
  • 2North Staffordshire Combined Healthcare NHS Trust, Stoke-on-Trent, United Kingdom.

Abstract

Clozapine is effective in treatment resistant schizophrenia; however, it is underutilised probably because of its side effects. The side effects are also the potential reasons for clozapine discontinuation. A mandatory requirement for its use is regular monitoring of white blood cell count and absolute neutrophil count. However there are many side effects that need monitoring in clinical practice considering their seriousness. This article tries to summarise the clinical concerns surrounding the serious side effects of clozapine some of which are associated with fatalities and presents a comprehensive way to monitor patients on clozapine in clinical practice. It emphasizes the need to broaden the monitoring beyond the mandatory investigations. This may help in improving the safety in clinical practice and increasing clinician confidence for greater and appropriate use of this effective intervention.

Keyword

Clozapine; Adverse effects; Drug monitoring; Practice guideline; Safety
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