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Ment Health Clin. 2019 Mar 1;9(2):64-69. doi: 10.9740/mhc.2019.03.064. eCollection 2019 Mar.

Psychiatric pharmacist's role in overcoming barriers to clozapine use and improving management.


Clozapine is an antipsychotic that exhibits superior efficacy and effectiveness for those with schizophrenia and other serious mental illness. However, its side-effect profile and administrative burdens present challenges to its use. In the United States, the medication is grossly underused even though it may improve outcomes and reduce costs. Current barriers to use include lack of prescriber knowledge and confidence, negative prescriber attitudes, special monitoring requirements, administrative factors, lack of clozapine on formularies, lack of support and infrastructure to use the medication within many health systems, and inadequate understanding or acknowledgement of clozapine prescribing and risks by policy makers and payers. Approaches using interprofessional models of care, which include pharmacists specializing in psychiatric care, can help meet the needs of patients receiving clozapine. This article lays out the big picture of barriers to clozapine and how psychiatric pharmacists could play a role in improving access.


barriers; clozapine; pharmacists

Conflict of interest statement

Disclosures: D.L.K. is on the advisory board for Lundbeck and a consultant for HLS Therapeutics. R.C.L. received a speaking fee for the Nevada Psychiatric Association and received an honorarium for the American Pharmacists Association Advisory Board on Pharmacist Administration of Medication from the National Alliance of State Pharmacy Associations for developing a white paper on medication administration by pharmacists.

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