SMI Adviser Clozapine Center of Excellence

Education, resources, and evidence-based answers to help you optimize the use of Clozapine
/ About / Clozapine

Welcome to the Clozapine Center of Excellence (COE)

SMI Adviser created the Clozapine COE to promote the safe and effective use of clozapine. The ultimate goal of this effort is to improve the lives of individuals who have treatment-resistant schizophrenia. The Clozapine COE provides clinicians with training opportunities, technical assistance, and vetted resources. These include:

  • Live and on-demand webinars
  • Virtual Learning Collaboratives
  • Virtual Forums
  • Email listserv
  • On-demand consultations
  • Intensive consultation to sites or communities
  • Clinical tips and resources

The Clozapine COE is led by SMI Adviser Physician Expert, Robert Cotes, MD, SMI Nursing Expert, Donna Rolin, PhD, APRN, and SMI Adviser content partner, National Association of State Mental Health Program Directors (NASMHPD), and supported by members of the Clozapine Workgroup.

For individual and family resources on using clozapine, visit the Individuals and Families Knowledge Base.

After 30 years,

Clozapine is still best for treatment-resistant patients

  • Resources
  • Education
  • Join Us
  • Consultation
Clozapine in the Elderly and Those with Medical Comorbidity, and Care Transitions

Clozapine-Related Adverse Events and Managing Inadequate Response

Addressing Barriers to Clozapine Underutilization

It Takes a Village: Interdisciplinary Approaches to the Use of Clozapine

Strategies for Successful Use of Clozapine: A Practical Guide

Managing the Side Effects of Psychotropic Medications

Psychotropic Medications and Older Adults: Update on Safety Considerations

Maximizing Treatment Success for Patients with SMI: Promoting Adherence and Treatment Engagement

Join the Clozapine and LAI Centers of Excellence Exchange

The Clozapine and LAI Centers of Excellence Exchange engages psychiatrists, nurses/nurse practitioners, pharmacists, and other clinicians, providing an opportunity to collaborate on the use of clozapine and long-acting injectables. Sign up for this listserv and join the conversation!

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Clozapine & LAI Virtual Forum

Join us for a live peer-to-peer discussion each month to share your challenges and questions on trending topics around clozapine and LAIs. Sign up for the Clozapine and LAI Centers of Excellence Exchange above to receive email invitations.

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Get Expert Guidance on Questions Around Clozapine

Submit any questions you have on managing side effects, assessment and monitoring, medical comorbidities, and any other topic. Receive a response within one business day from one of our national experts.

Can clozapine cause urinary retention, and if so, what can be done about it?
Is clozapine contraindicated for breastfeeding mothers?
Can clozapine cause blurry vision, and if so what can be done about this?

Trending Topics

Use our Knowledge Base to find evidence-based answers and resources on Clozapine. Here are some popular topics — all vetted by our Clinical Expert Team.

How do I interpret clozapine or norclozapine blood, serum or plasma levels, what do these mean?

Clinician assessment of symptoms and side effects is the primary means of evaluating and adjusting clozapine treatment.…

What is Benign Ethnic Neutropenia and does it relate to low clozapine white counts?

Approximately one half of African Americans have neutrophil counts that are lower than the normal ranges reported…

Is weight gain a problem with clozapine, and what can be done?

Significant weight gain can occur in individuals who take clozapine, similar to some other antipsychotic medications. A…

How does one dose or titrate clozapine dosage when starting on this medication?

The dosage of clozapine is titrated up gradually, to minimize side effects and maximize effectiveness. Titration starts…

How should I transition, taper or discontinue an existing antipsychotic medication when starting clozapine?

When starting clozapine, if a patient is taking an antipsychotic medication and they are tolerating it, it…

Clozapine Tachycardia Side Effect

Most people have a resting heart rate between 60 and 100 beats per minute. A 15-minute brisk…

What can clinicians do when individuals have either a partial or no response to clozapine?

Although clozapine has a unique efficacy for individuals with treatment resistant schizophrenia, some individuals may have enduring…

Tips on Starting Clozapine


Tips on Monitoring


Tips on Common Side Effects


Tips on Important Uncommon Side Effects


Tips on Challenges


Guidelines, Research, & Tools


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