What is an important monitoring requirement for patients on clozapine?

Clozapine is an atypical antipsychotic that is particularly effective for treatment-resistant schizophrenia. One of the foremost concerns with clozapine treatment is the risk of agranulocytosis, a potentially life-threatening reduction in the number of neutrophils in the blood. Regular hematologic monitoring is mandated to ensure that patients maintain an adequate white blood cell count and absolute neutrophil count. This monitoring typically requires a Complete Blood Count (CBC) to be performed weekly for the first six months of treatment, then every two weeks for the next six months, and monthly thereafter. This protocol helps in the early detection of neutropenia or agranulocytosis, thereby allowing for timely intervention to prevent serious complications such as infections.

Other monitoring requirements related to clozapine, such as liver function tests, ECGs, and body mass index assessments, are important as well but do not receive the same level of mandated urgency. Liver function tests can be monitored periodically due to the rare risk of hepatic side effects, while ECGs may be considered if there are cardiac risk factors, and body mass index checks are relevant for managing weight gain associated with antipsychotics. However, these do not compare to the critical importance of vigilant