Psychiatric Bulletin (2008) 32: 262-265. doi: 10.1192/pb.bp.107.019174
© 2008 The Royal College of Psychiatrists
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Valproate as prophylaxis for clozapine-induced seizures: survey of practice

Anna Sparshatt, Senior Clinical Pharmacist, Eromona Whiskey, Principal Clinical Pharmacist and David Taylor, Chief Pharmacist

*Maudsley Hospital, Denmark Hill, London SE5 8AZ, email: David.Taylor{at}slam.nhs.uk

Declaration of interest

Funding for this study was provided by Sanofi-Aventis in the form of an unrestricted grant. D.T. has received research funding, and consultancy and speaking fees from Sanofi-Aventis and Novartis.

AIMS AND METHOD

To evaluate the prescribing of valproate in clozapine-treated individuals who may be at risk of seizure. We collected point-prevalent clinical characteristics and demographics of all in-patients prescribed clozapine in an acute mental health trust. Data were collected from case notes, electronic records and drug charts, and analysed against a set audit standard.

RESULTS

Data were collected for 81 in-patients. Of all deemed to be at risk of seizure (n=37) only 24% were prescribed valproate at a therapeutic plasma level.

CLINICAL IMPLICATIONS

The majority of patients prescribed clozapine at risk of seizures were not adequately protected from this risk. Clear guidelines are required.




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Community Patients prescribed Clozapine: high number rated 'at risk'
Joan Rutherford, et al.
PB Online, 16 Oct 2008 [Full text]