Course Summary

Expiration Date: 10/01/2028

Clozapine remains the gold-standard antipsychotic for individuals with treatment-resistant schizophrenia (TRS), offering superior outcomes in symptom control, suicide prevention, and hospitalization reduction. Despite its unmatched efficacy, clozapine remains underutilized due to complex risk management protocols and concerns about adverse effects, particularly neutropenia. The FDA-approved prescribing information recommends routine absolute neutrophil count surveillance for the duration of therapy. A global expert consensus recommends more individualized monitoring, including cessation of routine ANC checks after two years in stable patients. As regulatory guidance shifts and global consensus supports more individualized monitoring strategies, clinicians must stay informed to balance treatment access with patient safety.

Course Format

Homestudy

Course Syllabus

  • Introduction
  • History of Clozapine and the REMS Program
  • Treatment-Resistant Schizophrenia
    • Diagnostic Criteria and Clinical Assessment
    • Epidemiology and Prevalence
    • Clinical Burden and Outcomes
    • Treatment Considerations
  • Clozapine Adverse Drug Reactions
  • Clozapine-Induced Neutropenia: Updated Understanding
    • Early Risk Period and Epidemiologic Trends
    • Onset Pattern and Mechanism
    • Benign Ethnic Neutropenia (BEN) and Genetic Risk
    • Impact of the COVID-19 Pandemic on Monitoring Frequency
  • Updated Consensus Recommendations: Toward Smarter, Safer Clozapine Monitoring
    • Revised ANC Monitoring Schedule
    • Standardized ANC Thresholds for Treatment Cessation
    • Comprehensive ADR Monitoring Every 3 Months
    • Clozapine Serum Level Monitoring
    • Embracing a Shared Care Model
    • A Patient-Centered Paradigm
  • Moving Forward
  • Summary

Richard Daniels, PharmD, BCPS

Richard “Cole” Daniels earned his Doctor of Pharmacy(PharmD) from the Skaggs School of Pharmacy at the University of Montana in 2018. Throughout pharmacy school he completed a 3-year internship at Community Medical Center in Missoula, Montana in which he gained valuable experience in an acute care setting. Cole currently serves as a psychiatric clinical staff pharmacist at the Montana State Hospital. He has over 11 years of pharmacy experience having worked in several settings including retail, acute care, and inpatient psychiatric care. Cole has a diverse set of interests. However, acute care medicine, infectious disease, pain management, and asthma/COPD are a primary focus of his at the Montana State Hospital. He obtained board certification as a certified pharmacotherapy specialist in the Spring of 2022.

Elisabeth Gordon, BScPharm, RPh

Elisabeth Gordon earned her BSc(Pharm) from the University of British Columbia in 2004. After graduation, she worked in community retail pharmacies on Vancouver Island, before returning to her rural hometown of Salmon Arm. In 2016 and 2017, Elisabeth trained with Pallium Canada and Victoria Hospice to enhance her knowledge of end-of-life-care and palliative services. She is a volunteer medical supervisor for T1DOutreach, a peer support platform for adults living with type 1 diabetes, and a member of a Canadian peer support group for adults living with Birdshot Uveitis. Elisabeth enjoys working in a small, fast-paced rural pharmacy where she brings compassion and empathy to her everyday practice.