Clozapine in primary care

Abstract

Clozapine is the most effective antipsychotic, but is reserved for people with schizophrenia who have not adequately responded to two other antipsychotics. It has a high adverse event burden and requires close monitoring. Whether prescribed by the hospital specialist or the GP, the GP will often be responsible for the monitoring of adverse effects and overall health of patients taking clozapine. All health professionals managing these patients must register with a clozapine monitoring service. Serious adverse effects include neutropenia, agranulocytosis and myocarditis. Monitoring helps to prevent fatal outcomes. Changes to the dose of clozapine, especially treatment interruptions, should be discussed with the patient’s psychiatrist.