Psychosis Treatment Optimization Program


The Psychosis Treatment Optimization Program (PTOP) is a community program that works with people whose medication is not working well to treat their psychotic illness.

These individuals often continue to have symptoms such as hearing voices, believing people are trying to hurt them, and/or having trouble thinking and communicating clearly even when on medication. These symptoms get in the way of the person's ability to have good relationships, to work or go to school. 

Find out more about psychosis.

What is treatment-resistant psychosis?

About one-third of all individuals that have psychosis will not respond well to some antipsychotic medication. If a person does not respond well to two different antipsychotic medications, they are considered to be treatment resistant.

What services do we provide?

The first step in the program is for the individual to be assessed by our clinical team, consisting of nurses, psychiatrists, pharmacists, and a psychologist who work together with the individual to find new treatments that work better for them. 

Once the assessment is complete, one of our psychiatrists will meet with the individual and recommend a treatment plan.

What kinds of treatment are there?

Treatment can include:

Treatment optimization

Following an assessment, the psychiatrist may suggest other medications that may be helpful.

Clozapine monitoring

One of the medications that may be suggested for individuals is clozapine. Clozapine is a very effective medication for treatment resistant psychosis. This medication comes with a number of side effects, some of which can be serious. One serious but rare, side effect can affect the body's ability to fight infections by lowering white blood cells. This side effect can be safely monitored with regular blood work and support from trained staff to closely monitor the individuals they work with. This service is available for as long as the individual is on clozapine. Common side effects may include drowsiness, low blood pressure, increased heart rate, weight gain, constipation and excessive drooling. These side effects can also be managed with the support of the individual’s care team.

Cognitive Behavioural Therapy (CBT) for psychosis

Cognitive Behavioural Therapy (CBT) is a type of talk therapy where thoughts, feelings, and behaviours are explored. With psychosis, individuals may experience strange beliefs or may hear voices even while on medication. CBT targets these symptoms. Individuals will attend 15 to 20 weekly sessions with a trained CBT therapist.

Follow-up appointments

Regular follow-up appointments will be scheduled to monitor the individual’s progress with their treatment. During this time the individual continues to be followed by his/her treatment team at the Mental Health and Substance Use Centre in their community or their family doctor.

How do I access your services?

Referrals are made through your family doctor or your psychiatrist. You can ask your psychiatrist or family doctor to make a referral for you to the Psychosis Treatment Optimization Program (PTOP) clinic in your community.   

Where can I find Psychosis Treatment Optimization Program clinic locations?

PTOP Central Clinic (Burnaby, New Westminster, Coquitlam)
Royal Columbian Hospital 
#304 - 260 Sherbrooke Street, New Westminster  V3L 3M2
Phone: 604 528 5064
Fax: 604 520 4831

PTOP North Clinic (Port Moody, Port Coquitlam, Pitt Meadows, Maple Ridge, Langley)
Maple Ridge Mental Health Centre 
#500 – 22470 Dewdney Trunk Road, Maple Ridge  V2X 5Z6
Phone: 604 528 5064
Fax: 604 520 4831

PTOP South Clinic (Surrey, Delta, White Rock)
Surrey Mental Health and Substance Use Centre
#1100 13401 108th Ave, Surrey  V3T 5T3
Phone: 604 528 5064
Fax: 604 520 4831

PTOP East Clinic (Mission, Abbotsford, Chilliwack, Hope and Agassiz)
Mission Mental Health and Substance Use Centre
3rd Floor, 7298 Hurd Street, Mission  V2V 3H5
Phone: 604 814 5630
Fax: 604 814 5601


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