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Monitoring the Safe Use of Clozapine

A Consensus View from Victoria, Australia

  • Therapy in Practice
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Abstract

Clozapine is an important antipsychotic agent that has a unique profile of clinical benefits, but that has also been associated with several serious and potentially life-threatening safety concerns. In order to minimise the impact of haematological adverse events, health professionals treating patients with clozapine are currently required to register their patients on a centrally administered data network and to conform to strict protocols. The consensus statement documented in this article extends existing protocols by recommending monitoring of patients treated with clozapine for additional adverse effects during treatment. This consensus statement reflects the current practice at five major public psychiatric hospitals in Victoria, Australia, for the monitoring and management of clozapine-related adverse events, and has been implemented at these sites because of emerging safety concerns associating clozapine with cardiovascular and metabolic adverse effects.

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Acknowledgements

Drs Berger, Castle, Kulkarni and Ryan and Mr Kuluris have no conflicts of interest that are directly relevant to the content of this article. Dr Berk has received grants from Novartis and Mayne Pharma; Drs Dodd, Callaly and Jepersen and Ms Fitzsimons have received grants from Mayne Pharma; Dr Lambert has acted as a consultant to and received honoraria from Mayne Pharma and Novartis and has received grants from Novartis; Dr Pantelis has received grants from Novartis and honoraria from Novartis and Mayne Pharma; Dr McGorry has acted as a consultant for Novartis and Mayne Pharma and has received a grant from Novartis.

No sources of funding were used to assist in the preparation of this review.

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Authors and Affiliations

  1. Department of Clinical and Biomedical Sciences, Barwon Health, The University of Melbourne, Geelong, PO Box 281, Melbourne, VIC 3220, Australia

    Michael Berk, Joanna Fitzsimons &  Seetal Dodd

  2. Orygen Research Centre, Melbourne, Victoria, Australia

    Michael Berk, Timothy Lambert, Pat McGorry & Gregor Berger

  3. Community and Mental Health, Barwon Health, Geelong, Victoria, Australia

    Michael Berk, Bill Kuluris, Tom Callaly &  Seetal Dodd

  4. Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia

    Timothy Lambert, Christos Pantelis, David Castle, Sean Jespersen, Pat McGorry & Gregor Berger

  5. Office for Psychiatric Evaluation and Educational NewMedia (OPEN), The University of Melbourne, Melbourne, Victoria, Australia

    Timothy Lambert

  6. Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Sunshine Hospital, Royal Melbourne Hospital and National Neuroscience Facility, Melbourne, Victoria, Australia

    Christos Pantelis

  7. Alfred Psychiatric Research Centre, Melbourne, Victoria, Australia

    Jayashri Kulkarni

  8. Department of Cardiology, Barwon Health, Geelong, Victoria, Australia

    Elizabeth W. Ryan

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  1. Michael Berk
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  2. Joanna Fitzsimons
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Correspondence to Seetal Dodd.

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Berk, M., Fitzsimons, J., Lambert, T. et al. Monitoring the Safe Use of Clozapine. CNS Drugs 21, 117–127 (2007). https://doi.org/10.2165/00023210-200721020-00003

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