{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T03:33:50Z","timestamp":1777520030457,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[1992,9,1]],"date-time":"1992-09-01T00:00:00Z","timestamp":715305600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can J Psychiatry"],"published-print":{"date-parts":[[1992,9]]},"abstract":"<jats:p>Clozapine is an atypical neuroleptic agent that has recently become available in Canada with potential clinical efficacy in the treatment of refractory schizophrenia, and in patients with schizophrenia neurologically intolerant to conventional neuroleptics. Although it causes few extrapyramidal symptoms, the drug has a number of other adverse effects including a risk of agranulocytosis in one to two percent of all patients. Because of this, the use of the drug is permitted only if the white blood count is monitored weekly. The monitoring system, outlined in this article, requires a coordinated effort between clinical staff, pharmacy, laboratory and the Clozaril Support and Assistance Network. Clinical guidelines are proposed, detailing the indications and contraindications for treatment and the pharmacokinetics, dosing, adverse effects, and drug interactions with clozapine. In addition, the economics, government policies and implications for future research are considered. Although there are administrative and clinical difficulties associated with its use, clozapine represents an advance in therapeutic research. Patients and family members will be inquiring about the drug and many deserve a trial. This article aims to inform Canadian mental health professionals about the safe and beneficial use of clozapine.<\/jats:p>","DOI":"10.1177\/070674379203700704","type":"journal-article","created":{"date-parts":[[2017,4,26]],"date-time":"2017-04-26T04:09:22Z","timestamp":1493179762000},"page":"482-488","source":"Crossref","is-referenced-by-count":14,"title":["Clozapine in the Treatment of Refractory Schizophrenia: Canadian Policies and Clinical Guidelines\n                    <sup>*<\/sup>"],"prefix":"10.1177","volume":"37","author":[{"given":"E.J.","family":"Collins","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of Toronto, Toronto, Ontario; Canadian Clozapine Advisory Board."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Lalonde","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec; Canadian Clozapine Advisory Board."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.D.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Ottawa, Ottawa, Ontario; Canadian Clozapine Advisory Board."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Addington","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Calgary, Calgary, Alberta; Canadian Clozapine Advisory Board."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.J.","family":"Maccrimmon","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, McMaster University, Hamilton, Ontario; Canadian Clozapine Advisory Board."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.W.","family":"Macewan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of British Columbia, Vancouver, British Columbia; Canadian Clozapine Advisory Board."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.D.","family":"Teehan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia; Canadian Clozapine Advisory Board."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[1992,9,1]]},"reference":[{"key":"bibr1-070674379203700704","first-page":"329","volume":"50","author":"Lieberman JA","year":"1989","journal-title":"J Clin Psychiatry"},{"key":"bibr2-070674379203700704","doi-asserted-by":"publisher","DOI":"10.1016\/0010-440X(90)90038-T"},{"key":"bibr3-070674379203700704","first-page":"722","volume":"40","author":"Fitton A","year":"1990","journal-title":"Drug Evaluation"},{"key":"bibr4-070674379203700704","first-page":"746","volume":"323","author":"Baldessarini RJ","year":"1991","journal-title":"N Engl J Med"},{"key":"bibr6-070674379203700704","doi-asserted-by":"publisher","DOI":"10.1038\/350610a0"},{"key":"bibr7-070674379203700704","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1985.tb01268.x"},{"key":"bibr8-070674379203700704","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1988.01800330013001"},{"key":"bibr9-070674379203700704","doi-asserted-by":"publisher","DOI":"10.1097\/00004714-198712000-00002"},{"key":"bibr10-070674379203700704","doi-asserted-by":"publisher","DOI":"10.1007\/BF00442563"},{"key":"bibr11-070674379203700704","first-page":"892","volume":"41","author":"Meltzer HY","year":"1990","journal-title":"Hosp Community Psychiatry"},{"key":"bibr12-070674379203700704","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1990.01810220061007"},{"key":"bibr13-070674379203700704","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.158.4.503"},{"key":"bibr14-070674379203700704","unstructured":"SchatzbergAF, ColeJO. Manual of clinical psychopharmacology, second edition. Washington DC: American Psychiatric Press, Inc., 1991: 98."},{"key":"bibr15-070674379203700704","first-page":"850","volume":"41","author":"Revecki DA","year":"1990","journal-title":"Hosp Community Psychiatry"},{"key":"bibr16-070674379203700704","first-page":"882","volume":"41","author":"Honigfeld G","year":"1990","journal-title":"Hosp Community Psychiatry"},{"key":"bibr17-070674379203700704","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1176\/ajp.148.10.1406-b","volume":"148","author":"Perry PJ","year":"1991","journal-title":"Am J Psychiatry"},{"key":"bibr18-070674379203700704","unstructured":"Product monograph for Clozaril (clozapine tablets). Dorval QC: Sandoz Canada Inc., 1991."},{"key":"bibr19-070674379203700704","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.149.1.68"},{"key":"bibr20-070674379203700704","first-page":"102","volume":"52","author":"Anderson ES","year":"1991","journal-title":"J Clin Psychiatry"},{"key":"bibr21-070674379203700704","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.147.8.1069"},{"key":"bibr22-070674379203700704","doi-asserted-by":"publisher","DOI":"10.1007\/BF00442560"},{"key":"bibr23-070674379203700704","first-page":"21","volume":"52","author":"Szymanski S","year":"1991","journal-title":"J Clin Psychiatry"},{"key":"bibr24-070674379203700704","first-page":"55","volume":"185","author":"Collins EJ","year":"1992","journal-title":"Clozapine in treatment resistant schizophrenia. Royal Society of Medicine International Congress and Symposium Series"}],"container-title":["The Canadian Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/070674379203700704","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/070674379203700704","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:10:11Z","timestamp":1777392611000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.sagepub.com\/doi\/10.1177\/070674379203700704"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1992,9]]},"references-count":23,"journal-issue":{"issue":"7","published-print":{"date-parts":[[1992,9]]}},"alternative-id":["10.1177\/070674379203700704"],"URL":"https:\/\/doi.org\/10.1177\/070674379203700704","relation":{},"ISSN":["0706-7437","1497-0015"],"issn-type":[{"value":"0706-7437","type":"print"},{"value":"1497-0015","type":"electronic"}],"subject":[],"published":{"date-parts":[[1992,9]]}}}