In general in the United States the use of clozapine is restricted to those people with schizophrenia who have failed first-line treatments. The reason for this restriction is
its risk of severe side effects
.
Why is clozapine not considered a first-line treatment for schizophrenia?
Clozapine is the most effective medication but is not recommended as first-line therapy
because it has a high burden of adverse effects, requires regular blood work
, and has not outperformed other medications in first-episode patients. Numerous guidelines or algorithms for the treatment of schizophrenia are available.
Why is clozapine different from other antipsychotics?
Clozapine differs from conventional antipsychotics
for its greater efficacy in controlling positive symptoms in people with treatment-resistant illness
and by inducing few extra-pyramidal effects (Kane 1988, Wahlbeck 1999).
Why was clozapine discontinued?
The most common ADR cited as a reason for discontinuation from a patient decision was
sedation
(n = 15), followed by nausea (n = 6), hypersalivation (n = 4) and weight gain (n = 4). Adverse drug reactions (ADRs) cited as a reason for discontinuation of clozapine for 80 patients (130 ADRs).
Why is clozapine bad?
Clozapine is an atypical antipsychotic used
for treatment-resistant schizophrenia
. A number of serious adverse reactions are associated with its use including: agranulocytosis, myocarditis, cardiomyopathy, and severe constipation (ileus).
What is the major side effect of clozapine?
Side Effects
Drooling, drowsiness, dizziness, lightheadedness, headache, shaking (tremor)
, vision problems (e.g., blurred vision), constipation, and weight gain may occur. Many of these effects (especially drowsiness) lessen as your body gets used to the medication.
What can trigger schizophrenia?
- bereavement.
- losing your job or home.
- divorce.
- the end of a relationship.
- physical, sexual or emotional abuse.
Does clozapine shorten your life?
Clozapine can cause severe adverse effects yet
it is associated with reduced mortality risk
. … Individuals prescribed clozapine had more severe psychopathology and poorer functional status. Many of the exposures associated with clozapine use were themselves risk factors for increased mortality.
What is the strongest anti psychotic drug?
Clozapine
, which has the strongest antipsychotic effect, can cause neutropenia. A problem in the treatment of schizophrenia is poor patient compliance leading to the recurrence of psychotic symptoms.
What works better than clozapine?
Loxapine
can be an excellent alternative to clozapine. It is comparable to clozapine in efficacy, cost-effectiveness, and a better side effect profile with more administration routes.
How do I stop taking clozapine?
If the discontinuation of treatment with clozapine is desired,
it should be gradually tapered off over several weeks
(50mg/week), rather than abruptly discontinued. Slow off-titration is preferred, if possible, to avoid withdrawal syndromes.
Is clozapine a high risk medication?
Clozapine is an
antipsychotic
medicine used to treat schizophrenia. But it can cause serious side effects.
Is clozapine a good drug?
It further showed that
clozapine fared better than 6 other drugs
(and polypharmacy), being associated with a substantially lower risk of death, including suicide, compared with a range of other antipsychotics, even those with more neutral metabolic side effects.
Does clozapine change your personality?
After three weeks, BPRS and GAF scores improved, as did impulsivity and mood (as measured by the Hamilton Rating Scale). 3) Other studies have demonstrated that clozapine
can decrease aggressive behaviors
(including self-mutilating behaviors), ameliorate relationships and decrease the frequency of hospitalization.
Does clozapine affect memory?
Clozapine is an effective antipsychotic drug, but
its effects on cognitive function are unclear
. Previously, we found that clozapine caused a working memory deficit, which was reversed by nicotine. Hippocampal systems are important in determining clozapine effect on memory.
Does clozapine lower your immune system?
This medication
can cause a serious immune system problem
called agranulocytosis (low white blood cells). To make sure you have enough white blood cells, you will need to have a blood test before you begin taking clozapine and then have your blood tested regularly during your treatment.
