belongs to the class of drugs called Antipsychotics.
primary use of this medication is to treat symptoms of acute or
chronic schizophrenia; it is often use in patients who have not
had adequate response to other antipsychotic drugs. Clozapine has
been found effective in Parkinson's disease, and and organic
disorders. though not approved for this indication, it has also
been used in the treatment of
symptoms will this drug help control?
of psychosis differ between individuals, both as to the type of
symptom and severity. Some common symptoms which antipsychotics
have been found to help include:
(e.g. hearing voices , smelling odors , feeling unusually body
beliefs, often of a paranoid nature (i.e. someone is
persecuting or following you; people are taking about you)
thoughts( difficulty in focusing on a thought ),or speeded-up
agitation, hyperexcitement, overelated mood
may also help symptoms of social withdrawal, lack of interest in
one-self and in others and poor motivation.
quickly will the drug start working?
begins to relieve agitation within a few days , helps control mood
changes in about 2 weeks , and help difficulties in thoughts and
awareness in 6- 8 weeks; hallucinations will decrease in intensity
and frequency over 2- 8 weeks . Some patients respond to clozapine
gradually over a period of months. Because antipsychotics
require time to work , do not decrease or increase the dose or
stop the medication without discussing this with your doctor.
long should you take this medication?
individuals that have had a psychotic illness for several years,
clozapine should be continued
indefinitely. The physician may adjust the dose, from time
to time, based on results of blood levels of clozapine and
response to treatment.
are blood tests necessary with clozapine and why is medication
given for a week at a time?
rare side effect (affects less than 1% of people) has been
reported with Clozapine; it is called agranulocytosis. With this
side effect, the white cells in the blood decrease in quantity,
which makes it difficult for the body to fight off any infections.
Because this can result in serious problem ,if identified early,
agranulocytosis can be reversed by stopping clozapine.
is therefore necessary to measure the amount of white blood cells
in the body on a weekly basis to identify those individuals who
may be at risk for agranulocytosis.
taking Clozapine for 6 months, individuals are no longer
considered at serious risk for agranulocytosis and may have the
blood work done, and may be given prescription for two weeks at a
effects occur, to some degree, with all medication. They are
usually mot serious and do not occur in all individuals. Most will
decrease or disappear with time. If a side effect continues, speak
to your doctor about appropriate treatment.
side effects that should be reported to your doctor at the next
and lethargy-This problem usually goes away with time. Use of
other drugs that make you drowsy will worsen the problem.
Avoid driving a car or operating machinery if drowsiness
up from a lying or sitting position ; dangle your legs over
the edge of the bed for a few minutes before getting up. Sit
or lie down if dizziness persists or if you feel faint, then
contact your doctor.
mouth- Sour candy and sugar less gum help increase saliva in
your mouth; try to avoid sweet, calorie- laden beverages.
Drink water and brush your teeth regularly.
Vision-this usually occurs at the start of treatment and may
last 1-2 weeks. Reading under a bright light or at a distance
may help ; a magnifying glass may be of temporary use. If the
problem continues, advise your doctor.
Increase bulk food in your diet (e.g. salads, bran) and drink
plenty of fluids. Some individuals find a bulk laxative (e.g.
Metamucil, Fibyrax) or a stool softener ( Colace, Surftak)
helps regulate their bowels. If these remedies are not
effective consult your doctor or pharmacist.
salivation or drooling-This often occurs at night. Use a towel
on the pillow when sleeping. If this also occurs during waking
hours, speak to your doctor about other remedies.
gain- Monitor your food intake; you may notice a craving for
carbohydrates (e.g. sweets ,potatoes, rice ,pasta but try to
avoid foods with high fat content (e.g. cakes and pastry)
or heart burn-If this happens take the medication with food.
effects you should report to your doctor immediately include:
of the mouth, gum or throat
weakness, fever or flu like symptom or other signs of
rash or itching
of blackouts or seizures
or persistent dizziness or fainting
urinating or loss of bladder control
tinge in the eyes or to the skin; dark -colored urine
to have a bowel movement (more than 2- 3 days)
of repetitive behavior or obsessional symptoms
Tardive dyskinesia is
an adverse effect that has been recognized in some patients who
have been treated with antipsychotics, usually for many years. The
risk of this adverse effect is considered to be very low, and
clozapine may help in treating this problem. Tardive dyskinesia
describes in voluntary movements of certain muscles- usually of
the lips and tongue, and sometimes those of the hands, neck and
other parts of the body.
your doctor know as soon as possible if you miss your
period or suspect you may be pregnant.
should you do if you forget to take a dose of your medication?
take your total dose of antipsychotic at bedtime and you forget to
take it, DO NOT take the dose in the morning, but continue with
your schedule the next day . If you take the drug several times a
day, take the missed dose when you remember, then continue with
your regular schedule.
with other medication
clozapine can change the effect of other medication, or may be
affected by other medication, always check with your doctor or
pharmacist before taking other drugs, including over- the -counter
medication such as cold remedies. Always inform any doctor or
dentist that you see that you are taking an antipsychotic
not increase or decrease your dose without consulting your
your drugs with meals or with water, milk or orange juice;
avoid grapefruit juice
as it may interfere with the effect of the drug.
drug may impair the mental and physical and mental abilities
required for driving a car or operating machinery. Avoid these
activities if you feel drowsy or slowed down.
drug may increase the effects of alcohol , making you more
sleepy, dizzy and lightheaded.
exposure to extreme heat and humidity (e.g. saunas) since this
drug may affect your body's ability to regulate temperature
( Gelucil, Maalox, amphogel, etc) interferes with the
absorption of these drugs in your stomach and therefore may
decrease their effect. To avoid this, take the antacids 2
hours before or 1 hour after taking your antipsychotic drug.
use of caffeinated beverages (coffee, tea ,colas, etc) can
cause anxiety , agitation, and restlessness and may affect the
blood level of your medication.
smoking can change the amount of antipsychotic that remains in
your bloodstream; inform your doctor if you make any changes
to your current smoking.
not stop your drug suddenly as this may result in withdrawal
symptoms such as nausea, dizziness, sweating, headache,
sleeping problems, agitation and tremor, and also result in
the return of psychotic symptoms.
your medication in a clean, dry area at room temperature. Keep
all medication out of reach of children.
have any questions regarding this medication, do not hesitate to
contact your doctor, pharmacist, or nurse.