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The use of clozapine in South Manchester

Department of Psychiatry, University Hospital of South Manchester, Manchester M20 8LR

We describe a survey examining the use of clozapine in South Manchester since 1990. The aims were to determine the patient characteristics, type of illness, response to treatment and recording of this information. The case-notes of the first 25 patients to receive clozapine between 1990 and 1992 were audited. Guidelines about who should receive this drug and what objective assessments should be performed were agreed by the consultant group. The audit demonstrated that 24 patients suffered from chronic schizophrenia which had failed to respond to conventional neuroleptics. Routine mental state examinations were regularly performed but objective assessments using standardised rating scales were employed infrequently. Sixteen out of 25 improved on clozapine but at the end of 1992 only ten subjects were still receiving this drug. The majority had been discontinued because of side effects.