About

Dr. Clayton English is an Assistant Professor of Pharmacy at the University of Washington School of Pharmacy. He earned his Bachelor of Science and Doctor of Pharmacy degrees from the University of Connecticut and completed a specialty residency in psychiatric pharmacy practice and clinical psychopharmacology at Nova Southeastern University College of Pharmacy. Dr. English holds board certifications in Psychiatric Pharmacy (BCPP), Pharmacotherapy (BCPS), and Geriatric Pharmacy (BCGP). His clinical experience includes serving as a clinical pharmacy specialist in psychiatry at the University of Vermont Medical Center, where he contributed to expanding inpatient psychiatric pharmacy services and trained students and residents. His academic career includes teaching neuropsychiatric therapeutics and psychopharmacology across pharmacy curricula. His research interests encompass neurologic and psychiatric pharmacy, focusing on the safe and appropriate use of psychiatric medications, psychotropic deprescribing, pharmacovigilance, mood disorders, adult ADHD, and drug-induced behavioral disorders. Dr. English is actively involved in professional organizations, serving as a Senior Editor for the American Association of Psychiatric Pharmacists' review resources, and has received multiple awards for his contributions to education and the pharmacy profession.

Research topics

• Psychiatry
• Political Science
• Medicine
• Medical education
• Nursing
• Psychology
• Pharmacology
• Family medicine
• Internal medicine

Selected publications

• Acceptability, Appropriateness, and Feasibility of Administering Long-Acting Injectable Antipsychotics in Community Pharmacies

  Psychiatric Services · 2026-02-05

  article1st authorCorresponding

  OBJECTIVE: Long-acting injectable antipsychotics (LAIAs) are evidence-based treatments for schizophrenia with demonstrated improved adherence and health outcomes relative to oral antipsychotics. Despite their benefits, LAIAs remain underprescribed. Administering LAIAs in community pharmacies could improve uptake, but the feasibility of integrating new services in this setting is often disregarded. The authors aimed to evaluate the feasibility, acceptability, and appropriateness of administering LAIAs in community pharmacies in Washington State. METHODS: Community pharmacy staff and psychiatric clinicians in Washington State were recruited, via both purposive and snowball sampling, through the Washington State Pharmacy Association and University of Washington's Department of Psychiatry and Behavioral Sciences. Participants' perceptions were assessed via a cross-sectional survey that included a questionnaire completed by pharmacy staff and three measures completed by psychiatric clinicians. For all outcomes, higher scores indicated more favorable responses. The data were analyzed with descriptive statistics. Simple linear regression models and comparisons across respondent groups were performed where possible. RESULTS: Ninety-three respondents initiated a survey; 89 met eligibility criteria. The pharmacists' mean scores were 4.98 (out of 6) for acceptability, 4.34 (out of 6) for feasibility, and 3.91 (out of 5) for appropriateness; the pharmacy technicians' mean respective scores were 5.43, 4.28, and 3.90. The clinicians' scores (measured on a 5-point Likert scale) were 4.20 for acceptability, 4.01 for appropriateness, and 3.92 for feasibility. CONCLUSIONS: The respondents surveyed viewed LAIA administration in community pharmacies as acceptable, appropriate, and feasible, indicating compatibility with early implementation efforts to support service development and expansion.

  PublisherDOI

• Pharmacogenomics and Psychiatry Care for Older Adults

  2025-01-01

  book-chapter1st authorCorresponding
  PublisherDOI

• Clozapine and tuberculosis treatment: a case report and literature review

  Frontiers in Psychiatry · 2025-07-09

  articleOpen accessSenior authorCorresponding

  Introduction: To date, clozapine is the only antipsychotic approved by the United States Food and Drug Administration (FDA) for the management of treatment-resistant schizophrenia. People with serious mental illness are at higher risk of developing tuberculosis and have worse tuberculosis recovery outcomes compared to the general population. First-line regimens for acute tuberculosis often include rifamycins and isoniazid, both of which impact clozapine metabolism and levels through induction or inhibition of the hepatic cytochrome P450 (CYP450) enzyme system. There is limited evidence, mostly from case reports, to guide clinicians in managing clozapine alongside anti-tuberculosis therapy (ATT). Literature review: = 3), the ATT regimen included both rifampicin, a CYP450 inducer, and isoniazid, a CYP450 inhibitor. We also review pharmacokinetic properties of rifampicin and the potential impact of rifamycin-based regimens on clozapine metabolism and levels. Case presentation: We present the case of a 35-year-old prescribed clozapine for 4 years prior to being diagnosed with pulmonary tuberculosis. The patient continued clozapine and was closely followed in both the inpatient and outpatient settings while completing a 6-month course of rifampicin, isoniazid, pyrazinamide, and ethambutol. During ATT, the patient had clozapine and norclozapine levels measured at least once monthly and maintained stability in their psychiatric symptoms through adjustment of clozapine and adjunctive antipsychotic dosages. Conclusion: Our case supports previous reports that ATT can influence clozapine levels. Clozapine dose adjustments will likely be required to maintain clinical stability and prevent adverse effects, but the management appears to be patient-specific. We recommend closely monitoring patients' clinical status and clozapine levels during and after ATT to optimize outcomes.

  PublisherOA PDFDOI

• Leveraging Change Management Principles to Implement Computer-Based Assessments in a PharmD Program

  American Journal of Pharmaceutical Education · 2025-11-01

  articleOpen access
  PublisherDOI

• Perceptions and practices of long-acting injectable antipsychotic administration in community pharmacies within Washington State: A qualitative implementation science study

  Journal of the American Pharmacists Association · 2025-11-03 · 1 citations

  article1st authorCorresponding
  PublisherDOI

• Xanomeline/Trospium Combination for Schizophrenia: Treatment Considerations for Older Adults

  Journal of Gerontological Nursing · 2025-05-29

  review1st authorCorresponding

  Purpose Xanomeline/trospium, a combination of a mixed muscarinic agonist/peripheral antagonist, is a novel treatment for schizophrenia that does not antagonize dopamine receptors. Given its unique pharmacology on the cholinergic system, special considerations may apply for older adults. Method The current article reviews the evidence of xanomeline/trospium in older adults as well as implications and considerations for use in practice. Results The evidence of using xanomeline/trospium is largely derived from the phase-3 EMERGENT clinical trial program, which investigated safety and efficacy in adults aged 18 to 65 years with schizophrenia. Significant reduction in psychosis was demonstrated; however, gastrointestinal effects were common. Conclusion Xanomeline/trospium is a novel treatment for schizophrenia that lacks many of the adverse effects associated with dopamine receptor blockers. Although the package insert provides guidance for use in older adults, patients aged >65 years were excluded from EMERGENT trials. Continued research is necessary to define the safety and place in therapy for older adults. [ Journal of Gerontological Nursing, 51 (6), 7–12.]

  PublisherDOI

• Provision of Mental and Behavioral Health Supports and Services by Pharmacists in Washington State

  Community Mental Health Journal · 2025-01-03 · 2 citations

  article1st authorCorresponding
  PublisherDOI

• Developing Community Pharmacist Prescribing Models to Expand Access to Medications for Opioid Use Disorder

  Journal of Addiction Medicine · 2025-09-12

  article

  OBJECTIVES: The Mainstreaming Addiction Treatment Act removed the separate registration requirement to prescribe scheduled medications for maintenance or detoxification treatment, creating an opportunity to utilize community pharmacists' expertise and accessibility to expand access to medications for opioid use disorder (MOUD). This study aimed to develop pharmacist prescribing models of care within community pharmacies. METHODS: Data were collected via interviews with community pharmacists and pharmacy technicians, treatment providers, and people with lived experience in Washington State from January to May 2024. Interviews were analyzed using a rapid content analysis approach guided by the Practice, Robust Implementation and Sustainability Model and existing evidence-based models of care for MOUD in primary care settings. The research team utilized the themes to develop models of care with input from an interdisciplinary advisory panel. RESULTS: Thirty-one interviews were conducted with 9 community pharmacy staff, 11 treatment providers, and 11 people with lived experience. In total, 21 themes were identified, including 8 themes regarding intervention characteristics, 5 regarding recipients, 5 regarding implementation and sustainability infrastructure, and 3 regarding external environment. Within intervention characteristics, 3 themes were identified regarding medication therapy, 3 regarding education, 1 regarding coordination of care, and 1 regarding psychosocial services. Two models of care were developed: one for MOUD initiation and another for maintenance or ongoing treatment. CONCLUSIONS: This study resulted in the development of models of care for MOUD initiation and maintenance at community pharmacies. Future research is needed to evaluate the effectiveness of these models of care.

  PublisherDOI

• Nefazodone shortage in the United States: analysis of drug switching and utilization

  Frontiers in Psychiatry · 2025-09-30

  articleOpen accessSenior authorCorresponding

  Introduction: Medication shortages and manufacturer discontinuations of antidepressants place patients in vulnerable scenarios if medications become inaccessible, leaving prescribers to alter therapy without guarantee of a sustained response to the new treatment. Methods: We conducted a descriptive retrospective analysis to explore changes in drug utilization and switching patterns following an FDA-declared nefazodone shortage in the United States. Using the Komodo Healthcare Map®, we analyzed prescribing patterns across the pre-shortage, shortage, and post-shortage periods. Results: A total of 7891 individuals were selected for inclusion, with 2185 eligible for the switching outcomes. A majority (96.4%) switched to an alternative medication, with an average time to switch of 106.8 days (SD: 81.7). Few patients resumed nefazodone use post-shortage (7.3%). Discussion: Although most patients transitioned to alternative antidepressants during the shortage, the need for treatment changes and the low rate of returning to the original medication may reflect challenges to patient-centered care. There is a need for clearer prescriber guidance to better support clinical decision-making during medication shortages.

  PublisherOA PDFDOI

• A call to action for ambulatory care pharmacists for the treatment of depression and anxiety in primary care: An opinion paper of the ambulatory care and central nervous system practice research networks of the American College of Clinical Pharmacy

  JACCP JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY · 2025-02-17

  article

  Abstract The need for mental health care has increased in recent years, especially due to the coronavirus disease 2019 pandemic. Simultaneously, the supply of mental health clinicians has declined alongside decreases in primary care clinicians. As management of depression and anxiety has increasingly moved to primary care, ambulatory care pharmacists must be equipped with the knowledge and skills needed to care for patients with these illnesses. The objective of this collaborative Opinion Paper of the Ambulatory Care and Central Nervous System Practice and Research Networks is to provide practical guidance on the role and educational needs of ambulatory care pharmacists in the management of depression and anxiety within primary care settings and to serve as a call for action. The authors performed a narrative review of the PubMed database from January 1, 1990 to November 10, 2024 using search terms pertaining to primary care pharmacists and mental health care. The reference lists of these articles were then reviewed for additional references. Ambulatory care pharmacists can help meet the increased need for mental health care in primary care. Their knowledge of evidence‐based medicine, drug interactions, adverse effects, and other areas of pharmaceutical care, coupled with their training in interprofessional team‐based care, make them an ideal addition to the primary care team to provide care for patients with depression and anxiety. A variety of educational programs are available for ambulatory care pharmacists to augment their mental health care knowledge and skills. Similarly, the training of pharmacists at all levels, from student to resident, should incorporate mental health experiences to prepare future pharmacists to address the mental health care needs of their patients. Ambulatory care pharmacists should leverage the skills and training they possess to fill the gap in care for patients living with depression and anxiety in primary care settings.

  PublisherDOI

Frequent coauthors

• James N. Gibson

  University of Washington Medical Center

  9 shared

• Jeffrey Bennett

  Indianapolis Zoo

  6 shared

• Jose A Rey

  Nova Southeastern University

  5 shared

• Kaeleb Laszlo

  Rutgers, The State University of New Jersey

  4 shared

• Zachary Schonrock

  University of Washington

  4 shared

• Molly Fassler

  University of Washington

  4 shared

• Kikka E. Delarose

  University of Washington

  4 shared

• Andrew Ly

  University of Baltimore

  4 shared

Education

• B.S., Pharmacy Studies

  University of Connecticut

• Other

  University of Connecticut

• M.S., Health Services – Clinical and Translational Research

  University of Washington

Awards & honors

• Award of Excellence in Academic Teaching from the University…
• Vermont Pharmacist of the Year by the Vermont Society of Hea…
• ACPHS Preceptor of the Year (2015)
• Teacher of the Year of the ACPHS Vermont Campus (2017, 2021)