costs. In case Batumi is the place of registration of a patient placed at Batumi Medical Centre, he/she is taken to the city for medical services with the help of a social worker. It is important that the services provided by the universal health care programme be available to all patients, regardless of their place of registration. The above problem was also indicated in the report of the European Committee for the Prevention of Torture following its visit to Georgia on September 10-21, 2018. According to the Committee, the fact that indigent mentally disordered in-patients are expected to fund their own somatic health care is absolutely unacceptable. The Committee recommends that urgent action be taken to remedy this problem.333 Patients who have been taking antipsychotic medications for a long time should undergo regular physical health examinations.334 Carrying out a blood and urine test alone, irregularly, fails to provide proper management of the side effects of antipsychotic medicines and increases the risk of late diagnosis of somatic (physical) diseases. In addition, in many cases, the results of laboratory tests remain beyond the attention of medical staff and the patient is not consulted or treated by the relevant specialist. The Special Preventive Group deems it important that attention be paid to the frequent use of Zopin335 (active ingredient Clozapine), without considering the international and national standards336 of the management of its side effects.337 The European Committee for the Prevention of Torture recommends in its report338 that the Georgian authorities take urgent steps to render regular blood tests mandatory 333 Report (CPT/Inf (2019)16) of the European Committee for the Prevention of Torture on its visit paid to Georgia on September 10-21, 2018, para. 128, available in English at: <https://rm.coe.int/1680945eca> [last accessed: 19.02.2020]. 334 Treatment and Management of Schizophrenia in Adults, National clinical practice recommendation (guideline), Chapter 4.7. 335 Treatment with Clozapine requires adherence to the prescription procedure and management of side effects. During treatment with Clozapine, it is not recommended to prescribe 12.5 mg as an initial dose and to gradually increase the dose. The drug should be prescribed in the doses of 50, 100 or 300 mg from the very beginning of treatment. For example, one of the patients was prescribed 50 mg of Zopin (Clozapine) twice a day in combination with Pzysin (Trifluoperazine). Another patient was prescribed 0.3 mg of Zopin in combination with 30 mg of Haloperidol three times a day. 336 Treatment and Management of Schizophrenia in Adults, National clinical practice recommendation (guideline), Chapter 4.7. 337 Clozapine monotherapy or the use of Clozapine in combination with other psychotropic drugs may develop orthostatic hypotension, bradycardia, syncope and cardiac arrest, as well as fatal myocarditis and cardiomyopathy. Stephen M.Stahl, A Pocket Guide to Atypical Antipsychotics. Dosing, switching, and other practical information < https://bit.ly/2xds5OG > [last accessed: 18.02.2020]. 338 Report of the European Committee for the Prevention of Torture on its visit paid to Georgia on September 1021, 2018, available at: <https://rm.coe.int/1680945eca> [last accessed: 21.01.2020]. 110

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