Optimizing Clozapine Use Through Therapeutic Drug Monitoring-Integrating Clinical and Laboratory Science Perspectives.

Clozapine, a second-generation antipsychotic, remains the most effective pharmacologic option for treatment-resistant schizophrenia, though it remains underutilized due to multiple factors, including patient concerns about adverse effects and limited prescriber familiarity with its optimal use. Therapeutic drug monitoring (TDM) is highly recommended for clozapine and can support individualized dosing, enhance safety, and improve clinical decision making by providing an objective measure of drug exposure. This article reviews the clinical application of clozapine TDM alongside laboratory methodologies, including immunoassays and mass spectrometry, highlighting how integration of clinical and laboratory perspectives can improve clozapine treatment.