American Board of Psychiatry and Neurology (ABPN) Practice Exam 2025 - Free ABPN Practice Questions and Study Guide

When considering the monitoring requirements for clozapine treatment, it is important to recognize that clozapine is unique among antipsychotics due to its association with agranulocytosis, a potentially life-threatening decrease in white blood cells (WBCs). This necessitates a stringent monitoring protocol.

Before initiating treatment with clozapine, it is mandatory to obtain a baseline WBC count to ensure the patient's baseline is within an acceptable range. This is critical for establishing safety regarding potential adverse effects on blood cell counts.

During the first week of treatment, patients are closely monitored with WBC counts performed a minimum of two times. This close monitoring helps detect any early onset of neutropenia that could occur as the body adjusts to the medication.

After the initial period of six months of stable treatment, WBC counts must be checked every two weeks. This schedule helps ensure that any late-onset side effects related to blood cell counts are promptly identified and managed.

However, monitoring with a weekly WBC count for four weeks following discontinuation of clozapine is not a standard requirement. The medical guidelines do not recommend this as a part of routine clozapine monitoring protocols. The correct focus is on the ongoing blood monitoring