Emergency discontinuation of clozapine is typically indicated when patients experience potentially life-threatening adverse effects, such as agranulocytosis, myocarditis, or neuroleptic malignant syndrome. In some situations, clozapine can be reinitiated once the clinical concern has resolved, or has been mitigated.
It was marketed from 1970. It began killing patients. After multiple deaths in Finland, it was banned there, and then across Europe. The major problem was 'agranulocytosis'.
Permanent discontinuation of clozapine treatment is recommended for patients showing evidence of agranulocytosis, myocarditis, cardiomyopathy, or QT prolongation greater than 500 ms if no alternative causes can be found.
Rapid discontinuation of clozapine has been reported to cause rebound psychosis and worsening of symptoms within 24 to 48 hours of drug cessation.
Clozapine may cause myocarditis (swelling of the heart muscle that may be dangerous) or cardiomyopathy (enlarged or thickened heart muscle that stops the heart from pumping blood normally).
However, research has shown that long-term use (7–11 years) of any antipsychotic treatment by people with schizophrenia is associated with lower mortality than no drug use and clozapine is associated with lower mortality than other commonly used first- and second-generation antipsychotic agents.
Clozapine is associated with several significant adverse effects, including agranulocytosis, neutropenia, constipation (which can be severe), myocarditis and adverse metabolic effects. These adverse effects are not necessarily dose-related and may occur at any time during treatment.
If the discontinuation of treatment with clozapine is desired, it should be gradually tapered off over several weeks, rather than abruptly discontinued, except in cases of emergency, such as agranulocytosis, and then only with close monitoring of the patient.
Clozapine is an antipsychotic medicine that helps to adjust the levels of dopamine and other chemicals available in your brain. Clozapine reduces dopamine activity where it is too high, helping with symptoms like hallucinations.
Clozapine may cause drowsiness, blurred vision, convulsions (seizures), or to have trouble with thinking or controlling body movements, which may lead to falls, fractures or other injuries.
Clozapine may increase the risk of death in older adults with dementia-related psychosis and is not approved for this use. You should not take clozapine if you are allergic to it.
Clozapine intoxication can be life-threatening. Outside of the common drug–drug interactions, tobacco smoking, and caffeine consumption, infectious and inflammatory processes are important contributors to clozapine intoxication.
A very common side effect of clozapine is sedation or drowsiness. This occurs in most patients when they are new to clozapine as they titrate the dosage up. Sedation is not always a problem, since early in treatment with clozapine, people are often agitated or psychotic, and sedation can be calming.
Background: Clozapine is the most effective antipsychotic in treatment-resistant schizophrenia but its use portends with a high burden of adverse reactions. One adverse event reported both in case reports and cross-sectional surveys is the emergence or worsening of obsessive compulsive symptoms (OCS).
Clozapine has unique and powerful side effects and risks, which often make it a drug of last resort.
Unlike other antipsychotics, long-term clozapine use is associated with increased odds of haematological malignancies. Long-term clozapine use has a higher effect on mortality due to lymphoma and leukaemia than due to agranulocytosis.
Yes, the 2013 study, Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: A multiple-treatments meta-analysis, published in the Lancet showed Clozapine as the number 1 antipsychotic in effectiveness. It was found to be 33% more effective than Olanzapine and 50% more than Haloperidol.
Loxapine can be an excellent alternative to clozapine.
We demonstrated that monotherapy with second‐generation oral antipsychotics performs best, especially with clozapine, followed by olanzapine and risperidone.
Drooling, drowsiness, dizziness, lightheadedness, headache, shaking (tremor), vision problems (such as blurred vision), constipation, and weight gain may occur. Many of these effects (especially drowsiness) lessen as your body gets used to the medication.
Do not drive, operate machines, swimming, climbing, or do anything else that could be dangerous until you know how this medicine affects you. This medicine can cause changes in your heart rhythm, such as a condition called QT prolongation. It may cause fainting or serious side effects in some patients.
Clozapine is an antipsychotic medicine that helps to adjust the levels of dopamine and other chemicals available in your brain. Clozapine reduces dopamine activity where it is too high, helping with symptoms like hallucinations.
Clozapine intoxication can be life-threatening. Outside of the common drug–drug interactions, tobacco smoking, and caffeine consumption, infectious and inflammatory processes are important contributors to clozapine intoxication.