
Psychiatry & Psychotherapy Podcast Clozapine & Schizophrenia with Michael Cummings, MD
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Mar 28, 2025 Dr. Michael Cummings, a leading psychopharmacologist and former head consultant at Patton State Hospital, shares his insights on treating schizophrenia with Clozapine. The discussion highlights the recent removal of the Clozapine REMS program, easing patient management. Key topics include optimal dosing practices, managing side effects, and drug interactions. Cummings also addresses the complexities of clozapine's associations with OCD and catatonia. The conversation underscores the importance of personalized strategies to improve patient outcomes while navigating the challenges of treatment.
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Abrupt Discontinuation
- Abrupt clozapine discontinuation can cause psychotic relapse and cholinergic delirium (nausea, vomiting, etc.).
- Use benztropine to mitigate cholinergic rebound.
Clozapine "Awakening"
- Patients on clozapine may experience an "awakening," realizing their life's lack of productivity post-psychosis.
- Psychotherapy can help address these new anxieties and develop life goals.
Akathisia from Risperdal
- A patient's pacing stopped after Risperdal discontinuation, suggesting akathisia (restlessness) induced by Risperdal, not clozapine.
- Clozapine doesn't typically cause movement disorders.

