Psychiatry & Psychotherapy Podcast

Clozapine & Schizophrenia with Michael Cummings, MD

77 snips
Mar 28, 2025
Dr. Michael Cummings, a leading psychopharmacologist and former head consultant at Patton State Hospital, shares his insights on treating schizophrenia with Clozapine. The discussion highlights the recent removal of the Clozapine REMS program, easing patient management. Key topics include optimal dosing practices, managing side effects, and drug interactions. Cummings also addresses the complexities of clozapine's associations with OCD and catatonia. The conversation underscores the importance of personalized strategies to improve patient outcomes while navigating the challenges of treatment.
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ADVICE

Clozapine REMS Removal

  • Clozapine REMS program is abolished, simplifying monitoring.
  • Exercise good judgment and follow package insert recommendations.
INSIGHT

Clozapine's Importance

  • Clozapine is underutilized for treatment-resistant schizophrenia.
  • Patients failing two antipsychotic trials have low odds of responding to other drugs, clozapine is their best option.
ADVICE

Clozapine Dosing

  • Start clozapine low (12.5-25mg) and titrate gradually, aiming for 350-600 ng/ml plasma levels initially.
  • Monitor levels, adjust based on response, and consider smoking status.
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