should be aware of this possibility even without other risk factors.This case highlights three important points. First early initiation of clozapine, as recommended by the Royal Australian and New Zealand College of Psychiatrists [6], can lead to strongly positive social and symptom outcomes that are recognized by the patient, family and professionals involved in care. Second the lower limit of the effect range, both by dose and by plasma level, is unclear and requires careful clinical review. In the present case, although plasma levels were very low, there was clear and sustained clinical effectiveness. Finally seizures can occur at low doses of clozapine, although this is rare. If they occur they can be effectively controlled with appropriate anticonvulsant medication and, in light of clozapine's proven superior effect, may be more appropriate than cessation of clozapine.
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