Clozapine : Therapeutic uses, Dosage & Side Effects
Clozapine is a second-generation atypical antipsychotic drug, used to treat severe schizophrenia, or to reduce the risk of suicidal behavior in people with schizophrenia or similar disorders.
Dose : 50-300 mg
Route : Oral
Plasma Half-life : 12 hours
Duration of action : ?
Bioavailability : 60 to 70%
Chemical formula : C18H19ClN4
IUPAC name : 8-chloro-11-(4-methylpiperazin-1-yl)-5H-dibenzo[b,e][1,4]diazepine
Trade name : Clozaril, Lozapin, Sizopin, Skizoril, FazaClo, Versacloz, Clopine, CloZAPine Synthon, Denzapine, Zaponex
Therapeutic uses : Clozapine has following usage :
- Primarily indicated as anti-psychotic drug for treating psychoses particularly Schizophrenia (generally first-line therapy). It may be effective in many patients who are resistant to the first generation agents, especially in treating the negative symptoms of schizophrenia (reserve drug in resistant schizophrenia).
- Effective for refractory schizophrenic patients.
- Can be for the management of the manic and mixed symptoms associated with bipolar disorder.
- Can be used as tranquilizers to manage agitated and disruptive behavior secondary to other disorders.
- May relieve anxiety.
- May be used as Sedative.
- May be used for Organic brain syndromes on a short-term basis.
- Rare indications includes Alcoholic hallucinosis, Huntington’s disease and Gilles de Ia Tourette’s syndrome.
Side effects : Adverse effects of the Clozapine can occur in practically all patients and are significant in about 80% ; Clozapine may produce following side effects:
- CNS ailments like Sedation, drowsiness, lethargy, mental confusion, increased appetite, weight gain, aggravation of seizures
- CVS effects including Postural (orthostatic) hypotension, palpitation, inhibition of ejaculation
- Anticholinergic effects such as blurring of vision, constipation, urinary incontinence
- Risk of worsening of diabetes,
- Agranulocytosis,
- Myocarditis,
- Bone marrow suppression,
- Hypersalivation,
- Hyperprolactinemia – amenorrhoea, infertility, galactorrhoea and gynaecomastia
- Rare Extrapyramidal disturbances (extrapyramidal symptoms EPS) such as Parkinsonism, Acute muscular dystonias, Akathisia, Malignant neuroleptic syndrome, Tardive dyskinesia.
Warnings :
- Severe Neutropenia, Orthostatic hypotension, Bradycardia, Syncope, Seizure, Myocarditis, Cardiomyopathy
- Increased mortality in elderly patients with Dementia-Related Psychosis,
Contraindications :
- It should be used cautiously in patients with seizure disorders (since it may lower the seizure threshold)or those with an increased risk for seizures, such as withdrawal from alcohol.
- Clozapine is contraindicated in patients with a history of serious hypersensitivity to Clozapine (e.g., photosensitivity, vasculitis, erythema multiforme, or Stevens-Johnson Syndrome) or any other component of Clozapine tablets.
For detailed query or in case of uncertainty, Always consult your doctor or pharmacist.
