Clozapine

Brand names

• Clozaril

Usage

Clozapine is used to treat schizophrenia after other standard medications have proved inadequate.

How it works

Clozapine inhibits activity of the brain chemical dopamine, thereby helping to prevent the over stimulation of specific nerve centers in the brain believed to be responsible for certain psychiatric disorders.

Side effects

Serious

Signs of serious infection, including high fever, chills, and sweating, sores or ulcers in the mouth, unusual bruising or bleeding, severe fatigue or weakness. Other serious side effects include seizures, yellow discoloration of the eyes or skin, rapid or irregular heartbeat, severe dizziness, severe low blood pressure (which may cause lightheadedness and fainting, especially when getting up suddenly from sitting or lying positions), and hyperglycemia (elevated blood glucose levels), with symptoms including increased thirst, hunger, and urination. If you experience such symptoms, seek medical help immediately.

Common

Increased salivation, dizziness, drowsiness, mild headache, constipation, nausea or vomiting, weight gain.

Less common

Abdominal pain, heartburn, sore throat, diarrhea, muscle aches, spasms, or weakness, loss of coordination.

Possible interactions

Other medicaments:

Clozapine may increase the effects of:

• antihypertensive medicaments; observe for excessive lowering of blood pressure.
• medicaments with atropinelike actions.
• medicaments with sedative actions (see benzodiazepines, etc.); observe for excessive sedation.

Clozapine taken concurrently with:

• other bone marrow depressant medicaments, such as carbamazepine (Tegretol), may increase the risk of impaired white blood cell production.
• buspirone (Buspar) may excessively elevate blood sugar and also lead to bleeding.
• carbamazepine (Tegretol) may increase risk of low white blood cells.
• cimetidine (Tagamet) can result in a toxic level of clozapine.
• erythromycin (E-Mycin, others) can result in increased clozapine concentrations and potential toxicity. This has been seen in a single case report, but caution is advised.
• fluoxetine (Prozac) can result in clozapine toxicity.
• fluvoxamine (Luvox) can result in clozapine toxicity.
• lithium (Lithobid, Lithotab, etc.) may increase the risk of confusional states, seizures and neuroleptic malignant syndrome.
• monoamine oxidase inhibitors (MAO inhibitors) may cause abnormally low blood pressure and exaggerated central nervous system response.
• nefazodone (Serzone) may lead to clozapine toxicity.
• paroxetine (Paxil) may lead to toxicity from either medicine.
• phenytoin (Dilantin) can cause a decreased clozapine level and result in breakthrough schizophrenia.
• risperidone (Risperdal).
• ritonavir (Norvir), and perhaps other protease inhibitors, may lead to increased risk of blood adverse effects or other adverse effects.
• sertraline (Zoloft) can result in clozapine toxicity.
• tramadol (Ultram) may increase seizure risks.
• venlafaxine (Effexor) may lead to clozapine toxicity.

Herbal medicines or minerals:

Kava and valerian may worsen drowsiness. Since part of the way that ginseng works is as an MAO inhibitor, combination with this medicine is not advisable.

Alcohol:

Avoid completely. Alcohol increases clozapine-induced sedation and can worsen possible undesirable side effects of clozapine on blood pressure and brain function.

Tobacco smoking:

May accelerate the elimination of this medicament and require increased dosage.

Marijuana smoking:

Moderate increase in drowsiness, worsening of orthostatic hypotension, increased risk of aggravating psychosis.

Exposure to heat:

This medicament can cause fever and can impair the body's adaptation to heat.

Occurrence of unrelated illness:

Infections must be vigorously treated. White blood cell response to infection must be followed closely.

Discontinuation:

If possible, this medicament should be discontinued gradually over a period of 1 to 2 weeks. If abrupt withdrawal is necessary, observe carefully for recurrence of psychotic symptoms.

Comments

From John Doe

Stay away from this "so called" medication, it will make you feel useless not too mention the endless trips for bloodwork. Do yourself a favor. DO NOT seek help from a psychiatrist, talk to your friends or family about what really led you too believe you have a mental illness.