Bloodwork & Tests
In the past weeks, the current health system has been adjusting to prepare for and mitigate the transmission of COVID-19. As a result, Health Canada has asked that health care providers who are prescribing and/or dispensing clozapine review the necessity of their patients conducting blood tests during this time. Health care providers are asked to use their clinical judgement to assess the benefits and risks of continuing treatment in the absence of laboratory testing. They are also asked to share this information with their patients and explain the risks associated with it.
This change in requirement for blood testing will be reassessed in three months or sooner. It is expected that once the COVID-19 related pressures are over, the required blood testing requirements will go back to what they were prior to this situation.
BCSS recommends that you talk with the health care provider to find how what this means for you exactly and what you can expect to do during this crisis.
Infections While on Clozapine
Clozapine is a very effective antipsychotic often used in the treatment of schizophrenia. Unfortunately, this medication can cause serious side effects such as delirium, myoclonus and seizures particularly when clozapine levels exceed the normal therapeutic range. Clozapine levels can increase as a result of medication interactions, changes in nicotine and caffeine consumption, liver disease and overdoses. In addition, clinicians must recognize infection, as a less widely known cause of increased clozapine levels.
Since the late 1990s, case reports of infectious processes causing toxic clozapine levels have emerged and recently a study was published based on research that supports these findings.
This is particularly important for family members caring for loved ones using clozapine during this time. If you observe an increased in side effects or the person is feeling unwell, contact your loved ones health care provider or physician.
- BC Mental Health & Addictions Services Psychopharmacology Newsletter (May/June 2009)
- COVID-19 Memo from CSAN® Clozaril Support and Assistance Network (March 2020)
- “Letter to the Editor: Around 3% of 1,300 Levels Were Elevated during Infections in a Retrospective Review of 131 Beijing Hospital In-Patients with More than 24,000 Days of Clozapine Treatment” (February 2020)