Clozapine
Clozapine (trade name
Clozaril®), approved by the
FDA in
1989, was the first of the
atypical antipsychotic drugs.
Clozapine was the first drug approved by the
FDA (
December 19,
2002) for reducing the risk of
suicidal behaviour in patients with schizophrenia.
History
Clozapine was developed by Sandoz in
1961, and introduced in Europe ten years later. In 1975, after reports of
agranulocytosis leading to death in some clozapine-treated patients, clozapine was voluntarily withdrawn by the manufacturer. Clozapine fell out of favor for more than a decade. However, when studies demonstrated that clozapine was more effective against treatment-resistant
schizophrenia than other antipsychotics, the FDA approved its use only for treatment-resistant
schizophrenia, and required regular haematological monitoring to detect
agranulocytosis.
Side Effects
Although clozapine is generally believed to not cause
tardive dyskinesia, it does cause
agranulocytosis in ~1% of users. In addition, common side effects include:
constipation,
drooling,
muscle-stiffness,
sedation,
tremors, and
weight-gain.
Agranulocytosis
Agranulocytosis can result in a dangerous loss of
white blood-cellss. Those who use clozapine are advised to have a blood cell count every
week, for the first 6
months of usage. After this they should continue to conduct said count every 2 weeks. If the number of white blood-cells drops notably, one should consult with a
hematologist. If you are using clozapine and have a
sore throat, or
fever, then you should inform a
doctor.
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