Intended for healthcare professionals

Letters Clozapine deaths

The art of clozapine therapy and “clozaphobia”

BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l484 (Published 05 February 2019) Cite this as: BMJ 2019;364:l484
  1. James Paul Pandarakalam, consultant psychiatrist
  1. Northwest Boroughs Healthcare NHS Foundation Trust, Hollins Park Hospital, Warrington WA2 8WN, UK
  1. james.pandarakalam{at}nwbh.nhs.uk

The BMJ’s article on clozapine deaths1 seems to increase “clozaphobia”—the fear of prescribing clozapine,2 which is potentially a transformative drug for people with schizophrenia. Since 1975, many clinicians have had reservations about its use because of the rare incidence of agranulocytosis and the unfortunate initial fatalities in Finland. The risk of developing granulocytopenia and agranulocytosis while taking clozapine is around 1.0%.3 It happens mostly in …

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