Clozapine is an atypical antipsychotic that is indicated for use in treatment-resistant schizophrenia. 1 In addition to its dopaminergic effects, it has potent anticholinergic, adrenolytic, antihistaminic and antiserotoninergic activity. 1 Related to its risks for adverse effects, clozapine use has been limited to those with treatment-resistant schizophrenia who fail to achieve an adequate clinical response or experience intolerable adverse effects with other antipsychotics. 1 Patients treated with clozapine are at risk for numerous adverse effects, some of which can be serious and possibly life-threatening. 2-4 These effects include bowel perforation, myocarditis, diabetes, death, seizures and agranulocytosis. 1-5 In addition, some of clozapine’s adverse effects may be due to its anticholinergic effects, such as dry mouth, sedation, constipation, drooling and orthostatsis. 6 Clozapine treatment is generally reserved for those with severe illness. 7 Given the potential for numerous adverse effects associated with clozapine use, it is important to identify guidelines that can be used to aid in the careful monitoring of inpatients initiating clozapine therapy. This review will examine the recent clinical guidelines for monitoring adult inpatients initiating clozapine therapy and identify the risks associated with clozapine therapy
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