Clozapine 101: Everything you need to know to start a new patient on clozapine-View Presentation

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Video Summary

The video presentation discusses the psychiatric drug Clozapine and its role in treating treatment-resistant schizophrenia (TRS) and associated symptoms like suicidality. Despite its potential benefits, Clozapine is underutilized, being prescribed to only 4-5% of patients with schizophrenia in the U.S., largely due to concerns over side effects and challenging initiation procedures. The presentation emphasizes the importance of using Clozapine for those with TRS, which constitutes about 23% of individuals from a first episode of schizophrenia.<br /><br />Presenters, including Dr. Rob Cotez, Dr. Oliver Freundreich, and Dr. Fred Nusifora, address various aspects of Clozapine. Dr. Nusifora discusses identifying candidates for Clozapine, noting that TRS might represent a distinct subtype of schizophrenia. He suggests that characteristics like early age of onset, family history, and cognitive deficits might indicate TRS. Dr. Cotez provides practical advice for starting patients on Clozapine and stresses a patient-centered approach, while Dr. Freundreich focuses on managing Clozapine's side effects.<br /><br />The discussion also covers the Clozapine REMS (Risk Evaluation and Mitigation Strategy) program, which requires regular blood monitoring to manage potential severe side effects like agranulocytosis. There is an ongoing debate about whether these monitoring requirements can be relaxed to improve patient access while maintaining safety.<br /><br />In summary, the presentation advocates for broader use of Clozapine under careful management and monitoring to improve outcomes for individuals with difficult-to-treat schizophrenia and related conditions. It also highlights ongoing challenges with regulatory requirements and emphasizes the need for continued research and education in the field.

Keywords

Clozapine

treatment-resistant schizophrenia

TRS

suicidality

side effects

underutilization

psychiatric drug

patient-centered approach

blood monitoring

agranulocytosis

REMS program

Dr. Rob Cotez

Dr. Oliver Freundreich