Clozapine is the only medication approved by the US FDA for treatment-resistant schizophrenia and remains highly underutilized for many reasons, including its unique side effect profile and required hematologic monitoring. This presentation will help build prescriber knowledge and confidence by taking a deep dive into clozapine’s pharmacodynamics and pharmacokinetics. Clozapine’s mechanism of action is not fully understood, but its receptor binding affinity differentiates it from other antipsychotics and may provide insights into the complex etiology of schizophrenia. We will review the proposed mechanism of clozapine side effects including neutropenia, myocarditis, sedation, orthostatic hypotension, constipation, and sialorrhea will discuss evidence-based management strategies. Clozapine has the potential to cause clinically relevant drug-drug interactions, which will be highlighted. Finally, we will discuss the value of obtaining clozapine levels and how to interpret them.
Speaker: Rob Cotes, MD