Clozapine is an antipsychotic drug that may be used to treat patients with schizophrenia who are unresponsive to, or intolerant of, conventional neuroleptics. It causes few extrapyramidal adverse effects and may be effective in combatting the negative symptoms of schizophrenia.
Clozapine has a relatively low affinity for D2 receptors and a much higher affinity for D4 receptors. Furthermore, it has some affinity for 5HT2 receptors. It is not clear exactly which aspects are responsible for its superior antipsychotic effect in treatment-resistant schizophrenia (1).
The major side effect is neutropaenia which is not dose-related and occurs in 1-2% of patients. For this reason, clozapine is contra-indicated in patients with a past history of neutropaenia. There has also been a recent update to information for prescribers regarding cardiac disease and clozapine and information regarding this is linked in the menu below.
One-third of patients with chronic intractable schizophrenia will respond within 6 weeks; about two-thirds within a year.
Monitoring (2)
Plasma level monitoring (2)
Target range
Inadequate response to antipsychotic treatment in schizophrenia and use of clozapine (1)
The summary of product characteristics should be consulted before prescribing this drug.
Reference:
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