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CASE VIGNETTE WHAT IS CLOZAPINE AND HOW DOES IT WORK? WHAT SYMPTOM TYPES CAN BENEFIT FROM CLOZAPINE? WHO IS A GOOD CANDIDATE FOR CLOZAPINE? WHY IS CLOZAPINE CONSIDERED MORE EFFICACIOUS THAN OTHER ANTIPSYCHOTICS? WHICH CLINICAL ASSESSMENTS AND LABORATORY TESTS SHOULD BE OBTAINED BEFORE BEGINNING CLOZAPINE? HOW SHOULD LABORATORY TESTS AND PHYSICAL FINDINGS BE MONITORED DURING CLOZAPINE TREATMENT? WHICH SIDE EFFECTS OF CLOZAPINE ARE PROBLEMATIC AND WHAT CAN BE DONE TO MANAGE THEM? WHICH DRUG-DRUG INTERACTIONS CAN LEAD TO TOXICITY OR LACK OF EFFICACY? WHEN SHOULD CLOZAPINE BE DISCONTINUED AND WHY? WHAT SHOULD I KNOW BEFORE DISCONTINUING THE CLOZAPINE TREATMENT? WHEN CAN CLOZAPINE BE REINITIATED AFTER ONSET OF A SERIOUS SIDE EFFECT? WHEN SHOULD I CALL A PSYCHIATRIST? CASE FOLLOW-UP CONCLUSION Clinical Points
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Rounds in the General Hospital February 17, 2022

Managing Clozapine in Primary Care Settings

Manjola U. Van Alphen, MD, PhD, MBA; Chirag M. Vyas, MBBS, MPH; Shreedhar Paudel, MD, MPH; Ahmed T. Makhlouf, MD; Sushrusha Arjyal, MD; Theodore A. Stern, MD

Prim Care Companion CNS Disord 2022;24(1):21f02948

LESSONS LEARNED AT THE INTERFACE OF MEDICINE AND PSYCHIATRY

The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.

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