How clozapine works. Clozapine is an antipsychotic medicine that helps to adjust the levels of dopamine and other chemicals available in your brain. Clozapine reduces dopamine activity where it is too high, helping with symptoms like hallucinations.
Clozapine is superior to other antipsychotics as a therapy for treatment-resistant schizophrenia and schizoaffective disorder with increased risk of suicidal behavior. This drug has also been used in the off-label treatment of bipolar disorder, major depressive disorder (MDD), and Parkinson's disease (PD).
Thus, clozapine's unique ability to correct deficits in cortical and limbic regions compared to other antipsychotic medications may be related to its efficacy in treatment resistant patients, but substantially more work is required to fully understand the mechanisms underlying clozapine's effectiveness for this ...
Background: Clozapine is an atypical antipsychotic demonstrated to be superior in the treatment of refractory schizophrenia which causes fewer movement disorders. Clozapine, however, entails a significant risk of serious blood disorders such as agranulocytosis which could be potentially fatal.
Based on time to discontinuation, clozapine was the most effective antipsychotic medication, as has been shown in Caucasian subjects.
Clozapine has unique and powerful side effects and risks, which often make it a drug of last resort.
Clozapine may cause drowsiness, blurred vision, convulsions (seizures), or to have trouble with thinking or controlling body movements, which may lead to falls, fractures or other injuries.
Loxapine can be an excellent alternative to clozapine.
Clozapine differs from conventional antipsychotics for its greater efficacy in controlling positive symptoms in people with treatment-resistant illness and by inducing few extra-pyramidal effects (Kane 1988, Wahlbeck 1999).
A very common side effect of clozapine is sedation or drowsiness. This occurs in most patients when they are new to clozapine as they titrate the dosage up. Sedation is not always a problem, since early in treatment with clozapine, people are often agitated or psychotic, and sedation can be calming.
Clozaril (clozapine) and Seroquel (quetiapine) are antipsychotic medications used to treat schizophrenia. Clozaril is also used to help reduce the risk of suicidal behavior in people with schizophrenia or similar disorders. Seroquel is also used to treat major depression and bipolar disorder.
Clozapine produced significant and long-lasting increases in dopamine release in the principal sulcus, and to a lesser extent, in the caudate nucleus. Haloperidol did not produce a consistent effect on dopamine release in the principal sulcus, although it increased dopamine release in the caudate.
However, research has shown that long-term use (7–11 years) of any antipsychotic treatment by people with schizophrenia is associated with lower mortality than no drug use and clozapine is associated with lower mortality than other commonly used first- and second-generation antipsychotic agents.
Conclusion. These findings show that clozapine enhances the motivation to work for food, that this effect is stable over repeated testing, and is independent of hunger state of the animal. This effect may relate to a combined action of clozapine at the serotonin 5-HT2C and histaminergic H1 receptors.
Such cognitive improvements with clozapine treatment may offer an advantage to patients with schizophrenia by enhancing the possibility of better vocational functioning and quality of life.
Clozapine is the most effective antipsychotic for the 25% to 33% of people with schizophrenia who are treatment resistant, but not all people achieve response.
Clozapine, which has the strongest antipsychotic effect, can cause neutropenia. A problem in the treatment of schizophrenia is poor patient compliance leading to the recurrence of psychotic symptoms.
Despite its superior efficacy and potential to reduce substantially the morbidity of schizophrenia and improve the outcomes, of patients, clozapine has not been used on a widespread basis or as a first-line treatment due to its potential for agranulocytosis.
Patients taking clozapine had more blood dyscrasias, hypersalivation, seizures, and sedation than those taking olanzapine, risperidone, or quetiapine.
Of the atypical antipsychotics, risperidone is the weakest in terms of atypicality criteria.
After twelve months of failed medication trials, my new psychiatrist introduced me to an older medication called clozapine, which some people refer to as a "wonder drug." He cautioned that the drug could cause me to gain 50 or even 100 pounds. But despite that risk, I knew I had to try it.
Do not drive, operate machines, swimming, climbing, or do anything else that could be dangerous until you know how this medicine affects you. This medicine can cause changes in your heart rhythm, such as a condition called QT prolongation. It may cause fainting or serious side effects in some patients.
Abrupt withdrawal of clozapine has been associated with symptoms of “cholinergic rebound,” including nausea, vomiting, hypersalivation, diarrhea, diaphoresis, insomnia, and agitation, as well as rapid onset of psychosis.
The time to peak concentration after oral dosing is about 2.5 hours. The elimination half-life is about 14 hours at steady-state conditions, plasma clearance between 8.7 and 53.3 L/h, and distribution volume between 1.6 and 7.3 L/kg.