Clozaril (clozapine) is an atypical antipsychotic predominantly used to treat schizophrenia. It is also used to prevent suicide in both schizophrenia and schizoaffective disorder. Clozaril should not be used in individuals with dementia, even if schizophrenia is also present.

Clozaril is usually used when patients do not respond well to other treatments; it is rarely the first-line treatment. This is because the medication often causes severe side effects of seizures and increased vulnerability to infection.

Patients who are suitable candidates for Clozaril find the medication works well; it alleviates symptoms of:

• Hallucinations
• Delusions
• Racing and/or unwanted thoughts
• Poor impulse control

Like most antipsychotics Clozaril works by influencing levels of neurotransmitters in the brain. Imbalances of these neurotransmitters are associated with the symptoms of schizophrenia and other mental disorders; restoring them to normal levels often resolves the issue.

Many schizophrenic patients respond poorly to medications, often for unclear reasons; the medications simply don't produce results. Several different medications may be tried before a productive one is found.

Treatment with Clozaril, assuming it produces results, can continue for as long as a doctor deems it beneficial.

Treatment Overview

Clozaril comes in tablets, which are scored for easy splitting. Food is optional. Tablets are usually taken twice per day.

Starting treatment with Clozaril is relatively complex. It should first be established that the patient is resistant to other medications, and after treatment starts regular doctor visits are necessary.

In most patients:

• Start with 12.5 mg taken once or twice per day.
• Dosage will be increased; often by 25 or 50 mg per day, but sometimes every few days.
• Most patients find 300 to 450 mg per day to be sufficient.
• Though unusual, some patients need a higher daily dose.
• Do not exceed 900 mg per day.

Dosage is gradually increased to help prevent certain side effects, such as low blood pressure. Doctor visits are not necessary every day, but until the ideal dose is found will probably be scheduled at least once per week. Doctors can also monitor for developing side effects that may not otherwise be apparent.

If a single dose of Clozaril is missed it should be skipped entirely until the next dose. If two consecutive doses are missed, treatment may need to start again at lower 12.5 mg doses. Speak with a doctor if two doses are missed.

Other medications can also influence dosage, including starting or stopping medication when Clozaril treatment is ongoing.

Results are variable; treatment typically spans at least a few months, especially considering at least half of the first month is spent titrating dosage.

When treatment ends, whether no longer providing benefit or due to side effects, it is best slowly reduced over a week or two. This isn't always possible depending on the severity of the side effect; if treatment must end abruptly, frequent doctor checkups may be needed for a few weeks.

Side Effects

Side effects from Clozaril are relatively common, but fortunately most are mild. Common side effects include:

• Drowsiness
• Dizziness
• Mild fever
• Headache
• Slow or rapid heart rate
• Drooling
• Sweating
• Low blood pressure
• Feeling faint or fainting
• Constipation

Clozaril can cause more serious side effects, which are generally dose dependent---the higher the dose, the higher the risk. Some of these side effects do not produce symptoms and can only be detected by a doctor with access to a laboratory.

• High fever
• Infection
• Inflammation of the heart
• Enlargement of the heart
• Seizures

If a seizure is experienced while taking Clozaril a doctor should be informed at once. Patients with a history of seizures are somewhat more likely to experience them while taking Clozaril.

This product---or any antipsychotic---should never be given to patients with dementia; it puts these patients at increased risk of death.

Clozaril can interact with a number of other medications, producing potentially dangerous complications. Always double-check with a doctor before mixing Clozaril with any other medication.