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Starting clozaril in elderly.

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Does anyone have an experience of starting clozaril in elderly people. What is the protocol for that and can it be started in an elderly patient.

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Yes, it's been started in 3 or 4 patients with dementia that I've seen recently. They had each tried at least one typical and atypical antipsychotic during the last 6 months and were still hallucinating or were aggressive. In one patient the clozapine has worked very well although she is hypersalivating. In another it has calmed her down a bit although she still hallucinates quite markedly. The criteria for starting are the same as for adults and they need weekly blood counts to watch for neutropenia. Our trust has started using Denzapine which has its own monitoring service, apparently it's cheaper than Clozaril (why else?) with the CPMS which I thought was excellent.

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we were thinking of how to start clozapine in prison

as many times prisoners are transferred to MSU just for that reason

anyone has an expereince of that?

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Does anyone have an experience of starting clozaril in elderly people. What is the protocol for that and can it be started in an elderly  patient.

if it's for schizophrenia then it's no different to youger people other than maybe you'd want to go slower in the titration.

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Does anyone have an experience of starting clozaril in elderly people. What is the protocol for that and can it be started in an elderly  patient.

if it's for schizophrenia then it's no different to youger people other than maybe you'd want to go slower in the titration.

agreed... start low... go slow...

Watch out for postural hypotension and anticholinergic side effects (consti, drymouth, and delirium)...

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