Clozaril

Clozapine causes a particularly high rate of grand mal seizures, estimated at 4% to 5% in the first year. This is a very serious hazard. The drug frequently produces severe low blood pressure and increased heart rate, potentially resulting in cardiovascular collapse. It can also cause hypertension. It can cause fever and a flulike syndrome. Respiratory arrest 

Clozapine s anticholinergic effects can cause confusion and delirium as well as sedation and lethargy. The severity of withdrawal psychosis may be due to cholinergic rebound. Clozapine can aggravate or cause hypersalivation, glaucoma, constipation and ileus, and urinary retention (Baldessarini et al., 1991). Weight gain is also a potentially very serious problem. 

While reportedly producing fewer extrapyramidal reactions, clozapine can produce every one of the neurological reactions associated with neuroleptic use, including neuroleptic malignant syndrome (Anderson et al., 1991 Dasgupta et al., 1991) and tardive dyskinesia (Weller et al., 1993). 

Clozapine s efficacy has been highly touted to the public but in reality is questionable, even by conventional standards (see comments of 

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Clozapine (Clozaril) 400 500-800 25- and 100-mg tablets FazaCIo (orally disintegrating tablets) 25 and 1 00 mg... 

The first of the second-generation, or atypical, antipsychotics was clozapine. Clozapine (Clozaril) is relatively free of the movement disorders that characterize the first-generation drugs. This is true of, and defines, second-generation, atypical antipsychotics. It was a significant breakthrough for schizophrenia patients. 

Clozapine (Clozaril). Clozapine was introduced over 30 years ago but has only been available in the United States since 1990. It remains the medication of choice for treatment-resistant schizophrenia. Since its introduction, it has been used to treat acute mania with excellent results. Furthermore, it avoids the potential for tardive dyskinesia posed by haloperidol and the other typical antipsychotics. 

The seeds of this transformation were sown some years ago. The first so-called atypical antipsychotic, clozapine (Clozaril), was devised in the 1960s. Clozapine was used widely in Europe until a series of deaths from a toxic hematological (blood) side effect called agranulocytosis occurred in the mid-1970s. Clozapine resurfaced in the 1980s and was approved for use (under strict guidelines) in the United States in 1990. Since that time, several other atypical antipsychotics have been approved, and others loom on the horizon. 

Clozapine (Clozaril). Clozapine has been available in other parts of the world for about 30 years. The FDA has only approved it since 1990. Clozapine is clearly the... 

Of all these treatments, the only consistent improvement is seen with the atypical antipsychotic clozapine (Clozaril). Treatment-resistant TD is in fact one generally accepted indication for nsing clozapine. However, becanse of the expense of this drug, the risk for granulocytopenia, and the reqnirement for biweekly blood draws, other measures should hrst be tried. 

Well, what happened when I was on Zyprexa and Clozaril was I was finally happy. I finally had relief of my symptoms. But I also had no clue how far it was going to go before I recognized I didn t look like myself anymore. I looked in the mirror and felt like an alien. I felt like I was no longer a woman. I didn t feel the same way sexually with men. I didn t feel the same. 

Since the implementation of the Clozaril National Registry in the United States, the estimated rate of agranulocytosis has been estimated to be 0.38% on the basis of data collected from February 1990 to December 1994 (Honigfeld 1996 Honigfeld et al. 1998). 

Kane J, Honigfeld G, Singer J, et al. Clozaril collaborative study group clozapine for the treatment-resistant schizophrenic a double-blind comparison with chlopromazine. Arch Gen Psychiatry 1988 45 789-796. 

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