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).
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 ...
Based on time to discontinuation, clozapine was the most effective antipsychotic medication, as has been shown in Caucasian subjects.
Its effects on other brain chemicals make it more effective and help offset some movement- and hormone-related side effects that other antipsychotics can produce. Clozapine is only used to treat schizophrenia when other medicines have not worked well.
Clozapine patients exhibited clinical improvement superior to that of chlorpromazine patients as assessed by the Brief Psychiatric Rating and Clinical Global Impression scales. These results suggest that clozapine is well tolerated and may be therapeutically superior to chlorpromazine in treating psychotic behavior.
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.
Clozapine has an average rating of 7.6 out of 10 from a total of 67 ratings on Drugs.com. 71% of reviewers reported a positive effect, while 19% reported a negative effect. Olanzapine has an average rating of 5.8 out of 10 from a total of 987 ratings on Drugs.com.
For many years, researchers have found that clozapine is substantially more effective than other antipsychotic medications in patients with treatment-resistant schizophrenia. See this SMI Adviser tip and this JAMA article.
Clozapine is regarded as the “gold standard” for treating schizophrenia. It is the only antipsychotic approved for treating the 20 to 30 percent of patients who do not respond to other medications, and especially those who are suicidal or violent.
Clozapine has an average rating of 7.6 out of 10 from a total of 67 ratings on Drugs.com. 71% of reviewers reported a positive effect, while 19% reported a negative effect. Risperidone has an average rating of 5.4 out of 10 from a total of 687 ratings on Drugs.com.
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.
Newer medications, called atypical antipsychotics, are also effective in relieving the symptoms of schizophrenia. These medications, including quetiapine, risperidone, and aripiprazole, are generally prescribed because they pose a lower risk of certain serious side effects than conventional antipsychotics.
Its lower rate of side effects and its greater effectiveness are probably the principal reasons for the better compliance of patients assigned to clozapine in this study than among those assigned to haloperidol. As in previous studies, there were few instances of agranulocytosis.
Loxapine can be an excellent alternative to clozapine.
The most severe and potentially life-threatening clozapine-related blood dyscrasias is neutropenia, which may eventually develop into clozapine-induced agranulocytosis or granulocytopenia. This occurs in roughly 0.8–2% of patients and requires mandatory hematological monitoring.
Clozapine has unique and powerful side effects and risks, which often make it a drug of last resort.
Dramatic differences exist in how widely clozapine – widely regarded as the “gold standard” of schizophrenia treatment – is prescribed from state to state, according to a new report published by the Treatment Advocacy Center.
The first antipsychotic medications, chlorpromazine and haloperidol, were dopamine D2 antagonists. These and similar medications are known as first-generation, typical, or conventional antipsychotics. Other antipsychotics, beginning with clozapine, are known as second-generation, atypical, or novel antipsychotics.
Clozapine is still a good choice in TRS, and it was found to be more effective than quetiapine. However, clozapine was associated with greater side effects than quetiapine.
Clozapine may cause dizziness, lightheadedness, or fainting when you stand up, especially when you first start taking it or when your dose is increased. Tell your doctor if you have or have had a heart attack, heart failure, or a slow, irregular heartbeat or are taking medications for high blood pressure.
Clozapine was associated with more sedation and hypersalivation than olanzapine, quetiapine and risperidone and with more seizures than olanzapine and risperidone.
Clozapine is not the first-line drug of choice due to its range of adverse effects, making compliance an issue for many patients. However, it also has some advantages, including lowering the risk of suicide and tardive dyskinesia and fewer relapses.
Agranulocytosis, (ANC less than 500/µL) should always lead to prompt permanent discontinuation of clozapine1. If myocarditis is suspected, and troponin is more than twice the upper limit of normal or CRP is over 100 mg/L, clozapine should be discontinued permanently.
This medication is used to treat certain mental/mood disorders (schizophrenia, schizoaffective disorders). Clozapine is a psychiatric medication (anti-psychotic type) that works by helping to restore the balance of certain natural substances (neurotransmitters) in the brain.
Clozapine is also indicated in patients with schizophrenia who show severe, untreatable adverse neurological reactions to other antipsychotics, including second-generation antipsychotics. Treatment with clozapine decreases overall mortality in schizophrenia, in part by reducing suicidality.