Clozapine

Please note: these are basic guidelines, refer to your doctor for a professional medical opinion.

Popular brand names:

Aspen Clozapine, Cloment, Leponex

Drug group:

Antipsychotic drug

Prescription needed?

Yes - all treatment is supervised by a consultant psychiatrist, and the patient and the pharmacist must be registered with the drug manufacturer.

What does it do?

Clozapine is an atypical antipsychotic drug used in the treatment of schizophrenia:

• Useful in severe resistant schizophrenia that has not responded to other treatments
• Also used when other drugs cannot be used due to intolerable side effects - Clozapine is less likely to cause parkinsonism (tremor/stiffness) than other antipsychotics

How should it be used?

• Do not take other medication without checking with your doctor or pharmacist – a number of drugs increase the risk of blood abnormalities
• Smoking lowers clozapine levels, thereby reducing its effect

What is the typical dosage?

Clozapine is given only under strict medical supervision and continual monitoring.

Your doctor will recommend a dosage tailored to your need, but typically:

• Total daily dose for adults: 12.5–900mg daily
• Given 1–2 x daily, a larger dose may be given at night

How quickly will it start to work?

Improvement is gradual, some effect within 3–5 days, but full beneficial effect (especially severe symptoms) may not be felt for some months.
              

How long will the effects last?

Up to 16 hours.

When should I stop using it?

Do not stop the drug without consulting your doctor.
           

Is it safe for prolonged use?

Long-term use may lead to blood problems (low white cell counts), abnormal liver functions, heart muscle problems, and significant weight gain.

The most serious side effect is a large and dangerous decrease in white blood cells (agranulocytosis).

Strict monitoring of the white cell count is therefore necessary - blood tests are needed before treatment, weekly for 18 weeks, fortnightly until the end of the first year, and every 4 weeks thereafter.                                                          

What are the possible side effects?

The following have been reported:

• More common: drowsiness, tiredness, dry mouth or excessive salivation, weight gain, fast heartbeat, dizziness, fainting, constipation, blurred vision
• Report to your doctor before taking your next dose if you experience: fever, sore throat, seizures

What other considerations are important?

Dosage may be adjusted by your doctor under certain conditions.

• Certain health problems: liver/kidney/heart/prostate problems, history of blood disorders, epilepsy/seizures, colon problems, previous bowel surgery, diabetes, glaucoma
• Other medicines: Sedatives, anticholinergic drugs
• Pregnancy and breast-feeding: Safety in pregnancy not established, may affect the breastfed baby
• Children: Not prescribed
• Over 60: Reduced dose necessary, increased risk of side effects
• Driving and hazardous work: Caution, the drug can cause blurred vision, drowsiness, and dizziness
• Alcohol: Avoid, enhanced sedative effects