Clozapine is uniquely effective in the management of treatment-refractory psychosis. However, many patients who are eligible to receive clozapine do not receive it, either because they have previously experienced adverse effects, or because of a reluctance to undergoing mandatory blood monitoring. At the National Psychosis Unit, a service designed for patients with treatment refractory psychosis, we specialise in helping patients to start to re-start clozapine under these circumstances. This presentation will combine research evidence and our own experience on the National Psychosis Unit to offer advice on improving the acceptability and tolerability of clozapine. I will cover common but troublesome problems such as hypersalivation and sedation, as well as the approach to re-challenging patients who have previously experienced suspected blood dyscrasias or cardiovascular complications of clozapine.