Clozapine in the General Hospital

I occasionally get questions from my colleagues on general medical and critical care units about how to order clozapine, a second-generation antipsychotic for patients with treatment resistant schizophrenia. It’s a difficult drug to use because of its many side effects and the need to titrate it carefully. This is by no means an exhaustive review and barely scratches the surface of the complexity involved in using clozapine for the treatment of schizophrenia. The Disclaimer certainly applies to this short slide set on the use of clozapine in the general hospital.


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By the way, the slide set was made by using WordPress Presentation Shortcode. If you don’t write the code just exactly right–it doesn’t work. That’s part of what some computer experts say is wrong with the Health Insurance Marketplace rollout. That’s not necessarily a knock against Obamacare, but it’s a fair opening for critics because there probably should have been an outside contractor to oversee the computer logistics. Can you get the paper enrollment forms at your public library? Are we sure that 100% of American households have a computer?



  1. Jim,

    Great presentation for what has to happen with clozapine in the general hospital. The lapse and retitration is critical.

    Regarding your comments on computer coding and the healthcare marketplace fiasco – I think everything including the EHR should be downloaded from NLM. When I proposed that for the EHR over a decade ago – people thought I was joking. Now we have EHR monopolies, massive annual licensing fees, tons of worthless documentation, and a clickfest every time you need to enter an order or reconcile medications.

    NLM has the premier medical reference site and if Congress was not interested in inventing a lot of low value cottage industries, NLM could apply that expertise to the EHR and the health care marketplace easily, efficiently, and for free (to the average consumer).


    • Thanks, George! This might be a dumb question, but does “NLM” stand for the National Library of Medicine? I went to the website, and it looks like it’s affected by the government shutdown. The home page has the message “Due to the lapse in government funding, the information on this web site may not be up to date, transactions submitted via the web site may not be processed, and the agency may not be able to respond to inquiries until appropriations are enacted. Updates regarding government operating status and resumption of normal operations can be found at

      I’m assuming NLM doesn’t stand for Nathan Lovett-Murray, an Australian footballer; the National Liberation Movement; NetWare Loadable Module; Network Lock Manager; New Libertarian Manifesto; or the Norwegian Lutheran Mission 🙂

      As always–WELL SAID!




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