Resource Availability
@ American Psychiatric Association. All rights reserved. This course material was originally created for SMI Adviser, and is now utilized with permission for the APAF SMI Learning Resource Center. The content in this course material is still current and relevant, yet, please be aware that some external resources and links may no longer be active or available.
Description
The key to keeping patients on clozapine is management of adverse effects and optimizing response. This presentation provides detailed practical information about strategies to mitigate weight gain, how to distinguish benign fever from other conditions (myocarditis, nephritis), and when to suspect cardiomyopathy. There is also a discussion of why routine seizure prophylaxis with divalproex is not necessary and might be harmful, and methods for addressing nonresponse.
Format
Recorded webinar, non-interactive, self-paced distance learning activity with post-test.
This presentation was recorded on June 1, 2020.
Learning Objectives
Discuss the rationale for and dosing of prophylactic use of metformin to manage clozapine-related weight gain.
Identify that seizures are easily managed and should never be a reason to discontinue clozapine treatment.
Express the conclusions that, due to the low prevalence of seizures, prophylactic anticonvulsants should not be used as these will be unnecessary in 98% of patients.
Diagnose myocarditis and interstitial nephritis, and distinguish these from benign fever and benign eosinophilia
Recognize the need for evaluation of cardiomyopathy
Explain that there is a known incidence of hematologic abnormalities other than neutropenia, including leukocytosis, neutrophilia, thrombocytosis, thrombocytopenia and anemia
Manage inadequate clozapine response
Outline
- Introduction & Learning Objectives
- Fever, Myocarditis, Interstitial Nephritis, Cardiomyopathy
- Managing Inadequate Response
Target Audience
Psychiatrist, Physician (Non-Psychiatric)
Instruction Level
Intermediate
Estimated Time to Complete
Estimated Duration: 1.0 hour
Program Start Date: June 1, 2026
Program End Date: June 1, 2029
Certificate of Participation
After completing the evaluation, participants will have the opportunity to download a certificate of participation. No continuing education credits are provided for this activity.
Faculty and Planner Disclosures
The American Psychiatric Association adheres to the ACCME's Standards for Integrity and Independence in Accredited Medical Education. Any individuals in a position to control the content of a CME activity - including faculty, planners, reviewers, or others - are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.
Faculty
- Jonathan Meyer, MD, Clinical Professor of Psychiatry, University of California, San Diego. Disclosures - Consultant: Acadia Pharmaceuticals, Alkermes, Abbvie, Intra-Cellular Therapies, Neurocrine; Speaker Bureau: Acadia Pharmaceuticals, Alkermes, Janssen Pharmaceutica, Neurocrine, Otsuka America, Inc., Sunovion Pharmaceuticals, and Teva Pharmaceutical Industries Ltd.
Program Planners
- Tristan Gorrindo, MD, American Psychiatric Association. Reports no financial relationships with commercial interests.
- Teri Brister, PhD, National Alliance on Mental Illness. Reports no financial relationships with commercial interests.
Accessibility for Participants with Disabilities
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Technical Requirements
This internet-based CME activity is best experienced using any of the following:
The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari
Internet Explorer 11+
This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player.
Optimal System Configuration:
Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)
Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)
Internet Connection: 1 Mbps or higher
Minimum Requirements:
Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content
Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content
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