Early and sustained treatment with clozapine represents the best available strategy for achieving and maintaining remission in patients with treatment-resistant schizophrenia.

Common side effects including sialorrhea, constipation and weight gain may result in poor adherence to treatment, while the existence of rare severe adverse events and the associated monitoring burden may result in delays in starting therapy.

Strategies for optimizing treatment and managing side effects are summarized and a checklist is provided.