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1975, after reports of agranulocytosis leading to death in some clozapine-treated patients, clozapine was voluntarily withdrawn by the manufacturer.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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