Clozapine has proven to be quite useful in the treatment of schizophrenia. It does tend to cause serious side effects if used improperly. Be sure to know the third-line treatment regimen to improve mood the right and safe way.
Clozapine is the generic name of the antipsychotic drug that blocks a number of brain receptors for neurotransmitters. It is primarily used to treat schizophrenia symptoms in individuals who have not shown adequate results from other drugs. Clozapine belongs to a drug class called atypical antipsychotics which changes the activity of substances and chemicals in the brain. The drug may also appear under brand names like Clozaril, Gen-Clozapine, Fazaclo and Leponex.
The drug comes in tablet form which should be taken orally. It also has a number of side effects that are considered lethal which explains why it was categorized under third line treatment. Clozapine has been shown to be more helpful in treating schizophrenia symptoms compared to older typical antipsychotic medications. Other indications for the drug include treating suicidal patients, paranoid individuals, manic patients, insomniacs and those suffering from schizoid personality, and dementia of the Lewy-body-type.
Drowsiness is the most common side effect of clozapine. Patients may also experience increased heart rate, headache, weight gain, sleepiness, tremor, increased salivation, hypotension, fever, blurred vision, difficulty urinating, constipation and paralytic ileus. Some symptoms may disappear after being on the drug for 2 to 3 days. Rarely, the drug may also cause extrapyramidal effects or sudden involuntary movements of the extremities, eyes and head. One serious side effect of the medication is agranulocytosis wherein white blood cell count drastically drops making the patient vulnerable to infection and other diseases. Other rare symptoms include seizures, myocarditis, jaundice, cardiomyopathy, pulmonary embolism, respiratory depression and chest pain. These should be reported right away.
Pregnant women and breastfeeding mothers should first consult their doctor before taking clozapine. The drug may interact with various drugs like risperidone, cimetidine, epinephrine, quinidine, anti-seizure medications, phenytoin, sedatives, SSRIs or selective serotonin reuptake inhibitors and tranquilizers. Doctors should be fully informed about any herbal medicine or nutritional supplement that the individual is taking to avoid adverse reactions. Patients with known allergic reaction to the drug are contraindicated. Individuals with history of liver disease, kidney problem, lung problem, hypotension, leukemia, hypertension, glaucoma, diabetes and mental illness should take the drug cautiously.
Clozapine acts by binding to serotonergic and dopamine receptors particularly dopamine at D1, D2, D3 and D5 receptors. It is also a 5-HT1A receptor partial agonist which in turn improves mood. Furthermore, it acts as an antagonist at various adrenergic, histaminergic and cholinergic receptors. Once clozapine is metabolized in the liver, it then binds to brain receptors improving dopamine and serotonin levels which are responsible for mood. As a result patients will exhibit improvement from schizophrenic symptoms.
24 schizophrenic patients were given clozapine for a span of 16 weeks. The initial dosage was 25 mg a day during the first week and amounts were increased every two weeks until patients took around 400 mg during the last 2 weeks. During the first 4 week, 14 patients showed significant improvement in symptoms. Another 6 patients improved during the next 4 weeks until 21 out of 24 were shown to be stable at the end of the study. These patients were provided with clozapine only after 2 other drugs were rendered ineffective.
Clozapine is a prescription medication and should only be purchased at legitimate pharmacies and clinics. There are sources that sell over the internet as well but consumers should make sure that these are authentic and certified. Consumers may ask for certification when buying online.
Avoid alcohol and tobacco products while taking clozapine since these may decrease the effectiveness or exacerbate drowsiness. Long-term use should also be monitored since tardive dyskinesia and agranulocytosis may result. Patients should expect results within the first 4 to 6 weeks but continuous improvements are possible over 6 months to 1 year.
Clozapine has the following structural formula:
• Molecular formula of clozapine is C18H19ClN4
• Clozapine available : 25mg tablets, 100mg tablets
Brand name(s): Asaleptin, Clozapin, Clozaril, Iprox, Leponex, Lepotex
Review published on: 19 March 2008
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