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Clozapine rapid retitration in the community: an assertive approach can prevent admissions

  • Nikola Nikolić (a1), Kevin Kilbride (a2) and Patrick Preston (a3)
Summary

Rapid retitration of clozapine may be necessary to reduce the known high risk of mental state destabilisation in patients who have had a 48 h treatment break. It may carry a high risk of complications, including seizures and myocarditis. We reflect on the literature on standard and rapid retitration and present a case of rapid retitration in the community. In this case, of a 54-year-old homeless man with treatment-resistant schizophrenia and polysubstance misuse, we safely retitrated clozapine in a community setting four times during a 6-month period; each retitration was completed over 4 days. We used a specific protocol based on his psychiatric history. We are now more confident in delivering clozapine retitration to other patients, thus preventing unnecessary admissions.

DECLARATION OF INTEREST

N. N. has received honoraria from Janssen Pharmaceuticals.

Copyright
Corresponding author
Correspondence Nikola Nikolić, HSE Dublin North East, c/o St Mary's Hospital, Acres Road, Dublin 20, Ireland. Email: nik.nikolic@sussexpartnership.nhs.uk
References
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BJPsych Advances
  • ISSN: 2056-4678
  • EISSN: 2056-4686
  • URL: /core/journals/bjpsych-advances
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Clozapine rapid retitration in the community: an assertive approach can prevent admissions

  • Nikola Nikolić (a1), Kevin Kilbride (a2) and Patrick Preston (a3)
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