Valproate as prophylaxis for clozapine-induced seizures: Survey of practice

Abstract

Aims and method: To evaluate the prescribing of valproate in clozapine-treated individuals who may be at risk of seizure. We collected point-prevalent clinical characteristics and demographics of all in-patients prescribed clozapine in an acute mental health trust. Data were collected from case notes, electronic records and drug charts, and analysed against a set audit standard. Results: Data were collected for 81 in-patients. Of all deemed to be at risk of seizure (n=37) only 24% were prescribed valproate at a therapeutic plasma level. Clinical implications: The majority of patients prescribed clozapine at risk of seizures were not adequately protected from this risk. Clear guidelines are required.