Establishment of a clozapine service within an Early Intervention (EI) for Psychosis service

Poster C91, Wednesday, October 10, 11:30 am - 1:00 pm, Essex Ballroom

Linda Mora1, Tahnee Bridson2, Nicole Garland1, Enrico Cementon1, John Cocks1, Brian O'Donoghue1,2,3; 1Orygen Youth Health

Linda Mora1, Tahnee Bridson2, Nicole Garland1 Enrico Cementon1, John Cocks1, Brian O’Donoghue1,2,3 1 Orygen Youth Health, 35 Poplar rd, Parkville, VIC 3025 2 Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia 3 Centre for Youth Mental Health, University of Melbourne, Australia Background The majority of young people with a FEP will achieve remission, however a proportion will experience persistent positive psychotic symptoms despite multiple trials of different antipsychotic medications. Clozapine is indicated in treatment resistant schizophrenia, however there are often long delays in commencing clozapine. In order to address this and to manage the required monitoring, a clozapine service was established within an EI service. Methods This study took place at the Early Psychosis Prevention and Intervention Centre (EPPIC), which provides comprehensive care to young people aged 15 to 24 with a FEP in Melbourne, Australia. All young people who commenced clozapine between 01.04.16 and 01.03.18 were included. Results In total, 38 young people were prescribed clozapine, however five had commenced prior to referral and therefore 33 were commenced in the clozapine clinic, 3 of whom had not yet reached 18 weeks. The mean dose of clozapine at 18 weeks was 395mg (±84). Mean weight at baseline: males 85.1kg (±20); females 77kg (±14.7), mean waist circumference at baseline: males 93.1cm (±15); females 88cm (±11.3). After 18 weeks treatment, the mean weight gain was 5kg (±8.6) and the mean increase in waist circumference was 4.9cm (±8.8). A total of 23% gained clinically significant weight (>7% gain) however 13% lost weight. Conclusion This service demonstrates that clozapine can be commenced in an EI service within a community setting and the protocols, procedures and staffing for the clinic will be discussed. Dieticians and exercise physiologists have been integrated to address these metabolic side effects.

Topic Area: Service System Development and Reform

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