Description
Real-world and clinical trial data support that clozapine is the only effective antipsychotic for treatment resistant schizophrenia and other severe mental illnesses. Clozapine also reduces rates of suicidality, psychiatric hospitalization and all-cause mortality. However, clozapine is underutilized for two reasons: misunderstandings of its efficacy benefits and misapprehension of, limited knowledge or misinformation about the management of treatment related risks and adverse effects. In response to worldwide efforts to promote clozapine use, this user-friendly Handbook provides clinicians with evidence-based approaches for patient management as well as logical approaches to the management of clinical situations and adverse effects. It outlines clearly the rationale for specific management decisions and prioritises the options based on this logic. This Handbook is designed for use by clinicians worldwide and is essential reading for all mental health care professionals.
Table of Contents
Preface; 1. Initiating Clozapine; 2. Understanding hematologic monitoring and benign ethnic neutropenia; 3. Binding profile, metabolism, kinetics, drug interactions and use of plasma levels; 4. Managing constipation; 5. Managing sialorrhea; 6. Managing sedation, orthostasis and tachycardia; 7. Managing metabolic adverse effects; 8. Managing seizure risk and stuttering; 9. Fever, myocarditis, interstitial nephritis, DRESS, serositis and cardiomyopathy; 10. Eosinophilia, leukocytosis, thrombocytopenia, thrombocytosis, anemia, hepatic function abnormalities; 11. Managing enuresis and incontinence, priapism, venous thromboembolism, neuroleptic malignant syndrome, tardive dyskinesia and obsessive compulsive disorder; 12. The efficacy story: treatment resistant schizophrenia, psychogenic polydipsia, treatment intolerant schizophrenia, suicidality, violence, mania and Parkinson's disease psychosis; 13. Addressing clozapine positive symptom nonresponse in schizophrenia spectrum patients; 14. Discontinuing clozapine and management of cholinergic rebound; 15. Special topics: child and adolescent patients, elderly patients, patients with intellectual disability, pregnancy and risk for major congenital malformation, lactation, overdose, postmortem redistribution; Index.
