The Online Journal of Clinical Audits, Vol 8, No 4 (2016)

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Evaluating the effectiveness of the Interventions outlined in the Maudsley Prescribing Guidelines for Common Side Effects of Clozapine

Panikos Stelios Michaelides, Julian Summerfield


Aims – A retrospective audit on the effectiveness of the Maudsley Prescribing Guidelines in managing common side effects experienced by patients prescribed clozapine for treatment resistant schizophrenia.


Methods – All patients receiving clozapine on our ward for at least six months had their case records accessed, and information regarding whether they had the following side effects was collected retrospectively (n=12); Sedation, weight gain, hypertension, constipation, tachycardia, postural hypotension and hypersalivation.


Results – 6 patients complained of being sedated but this subsided (n=6) by adjusting the dosage. Cardiovascular side effects where well monitored and managed either with beta blockers, referral to a cardiologist as well as close monitoring with ECG. Hypersalivation was the most common side effect (n=8) but was well contained with hyoscine hydrobromide. Weight gain was the most problematic side effect and was not well contained for any of our patients (n=6), with no intervention proving beneficial.


Conclusions – Staff need to be aware that the mean BMI of our patients is 30±8.3 and that physical health goals must be outlined and monitored in patients care plans. Staff to remind patients to choose healthy foods during meal times, outline physical health gaols in care plans and referral to exercise community exercise groups. Implementation of educational groups and activities on healthy living.

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