Clozapine initiation in crisis teams.

Aims: Our aim was to investigate the practicalities and success rate of clozapine titration in the community in a large sample of patients referred to three crisis teams in a defined geographical area. Methods: We collected data retrospectively of all the referrals for clozapine initiation to three crisis teams across Manchester during a three year period. Results: Out of a total of 6542 referrals, 66 were for clozapine initiation. From these referrals only 54 patients started clozapine, as the others declined the treatment. After commencing clozapine, a total of 46 patients (86.2%) completed the titration successfully. The main reason for discontinuing the clozapine titration in the community was withdrawal of patients' consent. Only one patient was unable to physically tolerate the titration and was admitted to hospital. Conclusions: Clozapine can be safely started in the community. Patients' adherence to the treatment and to the physical monitoring is the key element of a successful outcome. Crisis teams are in an ideal position to support patients undergoing initiation of clozapine at home. [ABSTRACT FROM AUTHOR]