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The assertive approach to clozapine: nasogastric administration
Alex Till1, James Selwood2, Edward Silva3
1Psychiatric Trainee,School of Psychiatry, Health Education North West (Mersey),UK.
Bjpsych Bulletin
|September 19, 2018
Summary
An assertive approach to clozapine, including nasogastric administration, safely treated extremely ill patients with treatment-resistant schizophrenia. This method improved mental state, reduced incidents, and allowed progression to less restrictive environments.
Area of Science:
- Psychiatry
- Clinical Pharmacology
Background:
- Clozapine is a highly effective treatment for treatment-resistant schizophrenia.
- Its administration can be challenging in extremely ill patients.
- An assertive approach, including nasogastric administration, offers a potential solution.
Purpose of the Study:
- To systematically describe the use and outcomes of an assertive approach to clozapine, including nasogastric administration.
- To evaluate the efficacy and safety of this approach in extremely ill patients with treatment-resistant schizophrenia.
Main Methods:
- A case-load analysis of five extremely ill patients with treatment-resistant schizophrenia.
- Inclusion of nasogastric administration as part of an assertive approach to clozapine therapy.
Main Results:
- Successful establishment and/or maintenance of clozapine therapy in all five patients.
- Significant improvements in mental state, reduction in incidents, and termination of segregation.
- Progression to less restrictive environments was achieved for patients.
Conclusions:
- An assertive approach to clozapine, even involving nasogastric administration, can be justified in extreme circumstances.
- Nasogastric clozapine delivery is safe and effective.
- The assertive approach itself may be key to maintaining patients on clozapine, rather than the mode of administration.
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