Focus on Clozapine

@article{Naheed2001FocusOC,
  title={Focus on Clozapine},
  author={Miriam Naheed and Ben Green},
  journal={Current Medical Research and Opinion},
  year={2001},
  volume={17},
  pages={223 - 229}
}
Summary Clozapine is a dibenzodiazepine derivative and a truly atypical anti-psychotic. Its therapeutic effects are probably mediated by dopaminergic and serotonergic activity. Although it appears to be the most effective antipsychotic drug for treatment-resistant schizophrenia, its general use is limited because of the risk of agranulocytosis. 

Revisiting Clozapine in a Setting of COVID-19

It is possible that clozapine may have therapeutic effects other than its antipsychotic effect and that needs further exploration, but these are early days to make any firm conclusions about the higher risks of COVID-19 posing to clozAPine treated patients.

Unique Effects of Clozapine: A Pharmacological Perspective.

Selective Serotonin Reuptake Inhibitors and Clozapine: Clinically Relevant Interactions and Considerations

Clozapine remains an effective drug against treatment-resistant schizophrenia, defined as failing treatment with at least two different antipsychotic medications, and supplementation of antipsychotics with SSRIs in schizophrenic patients with negative symptoms lead to synergistic improvements in the function of these patients.

Factors affecting interindividual differences in clozapine response: a review and case report

This review highlights all the conditions underlying a wide interindividual variability in the metabolism of clozapine, and analyzes them one by one.

Classics in chemical neuroscience: clozapine.

The history and importance of clozapine to neuroscience in general, as well as for the treatment of schizophrenia, are showcased, and the synthesis, pharmacology, drug metabolism, and adverse events of clazapine are reviewed.

NOVEL ATYPICAL ANTIPSYCHOTIC AGENTS

Atypical antipsychotic agents were developed in response to problems with typical agents, including lack of efficacy in some patient s, lack of improvement in negative symptoms, and troublesome adverse effects, especially extrapyramidal symptoms (EPSs) and tardive dyskinesia (TD).

Clozapine underutilization in treatment-resistant schizophrenia

Clozapine has been shown to provide superior therapeutic benefits and is approved as first-line therapy for TRS, and these benefits include improvement in both positive and negative symptoms, and reduction of suicidal behavior in patients with schizophrenia.

Clozapine versus other atypical antipsychotics for schizophrenia.

Comparing the clinical effects of clozapine with other atypical antipsychotics, any dose and oral formulations, for people with schizophrenia or related disorders and finding a certain higher efficacy is suggested.

Alcohol intake potentiates clozapine adverse effects associated to CYP1A2*1C in patients with refractory psychosis

Clinicians should be aware of this information before starting CLZ use, when treating patients with refractory psychosis, who are alcohol drinkers and carriers of this genetic variant in order to prevent CLZ‐related adverse reactions, and should be replicated in larger samples.

Mania Possibly Induced by Clozapine: a Case Report

A manic shift observed during clozapine use in a 30-yearold woman with schizoaffective disorder depressive type without any history of manic or mixed episodes was presented below.
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References

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Clozapine versus chlorpromazine for the treatment of schizophrenia: preliminary results from a double-blind study.

Clozapine appeared to be at least as effective as chlorpromazine without producing any extrapyramidal reactions, demonstrating that a drug can be effective antipsychotic without producing neurologic reactions.

Clozapine versus chlorpromazine for the treatment of schizophrenia: preliminary results from a double-blind study.

Clozapine appeared to be at least as effective as chlorpromazine without producing any extrapyramidal reactions, demonstrating that a drug can be effective antipsychotic without producing neurologic reactions.

Life-Threatening Allergic Reaction to Clozapine

The case of a 69-year-old woman, suffering from chronic schizophrenia, who developed an allergic asthmatic reaction following clozapine therapy, which could be repeated by further exposure to the drug.

Emergence of obsessive compulsive symptoms during treatment with clozapine.

Clozapine may produce or unmask obsessive compulsive symptoms, which may reflect a variation on the normal course of clinical improvement, or may more specifically result from clozAPine's atypical pattern of CNS receptor antagonism.

The Risks and Benefits of Clozapine versus Chlorpromazine

It is suggested that clozapine is well tolerated and may be therapeutically superior to chlorpromazine in treating psychotic behavior and agranulocytosis potential can be minimized by frequent white blood cell counts and removing nonresponding patients from treatment prior to the peak risk period.

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Maximizing clozapine therapy: managing side effects.

  • J. Lieberman
  • Psychology, Medicine
    The Journal of clinical psychiatry
  • 1998
Many side effects of clozapine are observed early after treatment onset and are greatly reduced by dose adjustments, which will facilitate a maximization of the benefits of clazapine treatment.

Optimizing treatment with clozapine.

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  • Psychology, Medicine
    The Journal of clinical psychiatry
  • 1998
If patients improve significantly during treatment with clozapine, they should continue to be treated with clazapine and should be withdrawn from this treatment only when medically warranted, although dosage must be individualized.
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