Antipsychotic Blood Levels, Part 1: Core Concepts, Sampling, and the Clozapine Algorithm The key points for this activity are: • Draw TDM levels 12 hours after the last dose. Repeat any level that raises clinical concern before making important treatment decisions. • Use TDM to verify prior failures involved therapeutic levels. Don't mistake non-adherence for true treatment resistance. • Do not rely on a single unrepeated clozapine level. Variation of 20 to 30% between assays is not unusual, even under normal circumstances. psychopharmacologyinstitute.…

I'VE HAD ENOUGH OF THE UK BLOODY COMPLAINT SYSTEM. I honestly don't know how we've got to this point in the UK where trying to get answers, justice and accountability has become an absolute bloody nightmare. We're constantly told. “ If something has gone wrong, make a complaint. ” So you do. And then you're thrown into a world of bureaucracy that quite frankly makes you want to scream. I've been dealing with this for years now. Health boards. Social services. Complaints departments. Regulators. Different organisations, different departments, different procedures... And I'm starting to realise something. The complaints system itself is part of the problem. Because when you make a complaint, it isn't as simple as making a complaint and someone properly looking into what happened. Oh no. You have to know who to complain to. Then you have to know what process you're supposed to be in. Then you have to know what the deadlines are. Then you wait. And wait. And wait some more. Then you chase. Then you get told someone will be in touch. Then you wait again. Then you chase again. And if you're lucky, eventually you get a response. And sometimes that response just creates another bloody list of questions. So you ask those. And then you're told you've reached the end of the complaints process. What?! How can someone be expected to get justice when the system is so complicated that you need to become an expert in complaints procedures just to navigate it? I've literally had to keep records of emails, dates, names, complaint references, responses, deadlines and everything else because otherwise I genuinely don't know how you'd keep track of it all. And I shouldn't have to. I'm not a complaints officer. I'm not a solicitor. I'm not a regulator. I'm a mum who has been trying to get answers and accountability. Yet somehow I'm the one doing the chasing. I'm the one having to remind people. I'm the one having to say: “ You haven't responded. ” “ You said you'd get back to me. ” “ What's happening with my complaint? ” And this is happening across different organisations. Even now, I've emailed the @The_HCPC Fitness to Practise team chasing an update. That was six days ago. I got an email back saying they would be in touch. And I'm still waiting. And yes, I know six days might not sound like a long time to some people. But that's not the point. It's the bloody pattern. I have had no updates since the complaint was logged. It's always waiting. Always chasing. Always another process. Always another department. Always another explanation. And after years of doing this, it becomes absolutely exhausting. And then I think about people who don't have the ability, time or energy to keep doing this. What happens to them? What happens when someone makes one complaint, gets told it's complicated, gets passed from one department to another and eventually thinks. “ Fuck it. I can't do this anymore. ” Do they get justice? No. They just disappear from the system. And that's what worries me. Because how many people have given up? How many families have stopped complaining because they simply couldn't face another fight? How many people have been told they're out of time, don't know how to challenge that, and just walk away? How many people don't even know what their rights are? I don't think we should have a complaints system that depends on how bloody determined you are. Justice shouldn't go to the person who can keep fighting the longest. And yet sometimes that's exactly what it feels like. I've had to fight and fight and fight just to get people to actually look at what happened. And I'm bloody tired. But I'm also angry. Because if we have departments whose entire purpose is to deal with complaints, investigate concerns and provide accountability, then they need to actually be fit for purpose. And if they're not? CHANGE THEM. Why are we so scared of saying that?

From NZ Health: Blood monitoring requirements for patients taking the psychiatric medicine clozapine will change from March 2027, helping reduce disruptions for patients while maintaining important safeguards. See bel… bsky.app/profile/health.govt…

The MHRA is considering changing monitoring requirements for clozapine. They should read this: thelancet.com/journals/lanps…