Use of Clozapine in the General Hospital.

Patients with treatment-resistant schizophrenia receiving clozapine therapy are at risk of potentially serious complications in the general hospital setting, due to the complex pharmacokinetic and pharmacodynamic profile of clozapine. We summarize common clinical challenges that face clinicians who care for clozapine patients in the general hospital, and make recommendations based on the available literature and clinical experience. Early collaborative management between consultation-liaison psychiatry and other clinical teams in the general hospital is paramount to improve clinical outcomes and avoid serious complications in this patient group.

Switching away from pipotiazine palmitate: a naturalistic study.

Background: In March 2015, pipotiazine palmitate depot antipsychotic was globally withdrawn due to the shortage of its active ingredient. Thus, all patients receiving this medication had to be switched to an alternative antipsychotic drug. In this study we set to evaluate the process of switching away from pipotiazine palmitate within our clinical service, and its impact on hospitalization.

Notes on the use of randomised controlled trials to evaluate complex interventions: Community treatment orders as an illustrative case.

Over the past seven decades, randomised controlled trials (RCTs) have revolutionised clinical research and achieved a gold standard status. However, extending their use to evaluate complex interventions is problematic. In this paper we will demonstrate that complex intervention RCTs violate the necessary premises that govern the RCTs logic and underpin their rigour.

Impact of Sudden Expansion of Catchment Area on Admissions to a Psychiatric Intensive Care Unit.

Purpose: The closure of a neighboring psychiatric intensive care unit (PICU) provided an opportunity to evaluate the number of PICU beds required per head of population and to explore how referrals to the PICU are prioritized.

Design And Methods: Data were collected and analyzed for admissions to our PICU in the year before and the year after the closure of the other unit.

Findings: Admissions increased (in year 2) by 42%, although there was no significant increase in the use of restrictive nursing interventions.