Clozapine: A Quick Glance

clozapine tablets

Clozapine is a drug used to treat people with schizophrenia. It is not an antipsychotic medication but an anti-psychotic type medication. But it has the same effect on symptoms of schizophrenia as other antipsychotics do. This blog post will discuss everything you need to know about clozapine, including what it does, important information that should be discussed with your doctor before taking it, how it should be taken, and what can happen if you don’t take it properly or overdose on the medication.

What Is Clozapine?

clozapine formula

Clozapine is an atypical antipsychotic medication that is used to treat schizophrenia and other psychotic disorders. It can also be used to treat the schizoaffective disorder and some cases of bipolar disorder.

Clozapine is the only medication that has been shown to reduce the risk of suicide in people with schizophrenia. It works by blocking certain receptors in the brain (Dopamine D-type, serotonin, histamine) that are involved in causing psychotic symptoms.

Atypical Antipsychotics

Atypical antipsychotics are a newer type of medication helps to treat schizophrenia and other mental illnesses. They work differently than older medications, called typical antipsychotics.

NOTE: Clozapine is the only atypical antipsychotic that is approved by the Food and Drug Administration (FDA) for treatment-resistant schizophrenia.

What Does Clozapine Treat?

Clozapine is helpful to treat the symptoms of schizophrenia. Schizophrenia is a mental illness that affects how a person thinks, feels, and behaves.

It is also used prescribed for treatment-resistant schizophrenia. It is a form of mental illness in which symptoms are not controlled by regular medications.

In addition, it also aids in psychosis related to dementia.

What Should You Discuss With Your Doctor Before Taking Clozapine?

You should discuss with your doctor all of the risks and benefits of taking this atypical antipsychotic before starting treatment.

Tell your doctor if you have:

  • Heart problems or any type of long QT syndrome
  • Seizure disorders or a family history of seizures
  • A brain tumor, stroke, or any type of bleeding in the brain
  • Diabetes
  • Hypothyroidism (low thyroid function)
  • Low blood pressure (hypotension),
  • Low white blood cell count, and/or
  • Anemia (a low red blood cell count)
  • Kidney disease
  • Liver problems
  • Pancreas problems

How Should You Take Clozapine?

This atypical antipsychotic is available as tablets, oral solutions, and in an injection form. It is taken by mouth once daily with or without food. You should take clozapine at the same time each day to maintain an even level of medication in your blood.

What Happens If You Miss A Dose Of Clozapine?

If you miss a dose of clozapine, take it as soon as possible. However, if it is nearly time for your next dose, skip the missed dose and continue with your regular schedule.

NOTE: Do not take two doses at once to make up for a missed dose.

What Should You Avoid While Taking Clozapine?

You should not drink alcohol while taking this atypical antipsychotic. Alcohol may increase the risk of life-threatening side effects. Such as seizures and serotonin syndrome.

Serotonin Syndrome

It is a rare but serious condition that can occur when you take certain serotonergic medications with this atypical antipsychotic. Symptoms include:

  • Agitation
  • Hallucinations
  • Fast heart rate
  • Nausea
  • Vomiting
  • Diarrhea
  • Muscle stiffness or twitching
  • Loss of coordination

What Happens If You Overdose With Clozapine?

Overdosing with this atypical antipsychotic can cause serious and life-threatening side effects. If you think you or someone else has overdosed with clozapine, call your doctor or poison control center right away.

Important Information You Should Know About Clozapine

Clozapine can cause serious side effects, including death.

There may be an increased risk for serious heart problems with clozapine. Especially if you have a pre-existing heart condition.

People with the following conditions should not take clozapine:

  • Heart problems or any type of long QT syndrome
  • Seizure disorders
  • A brain tumor
  • Stroke Diabetes
  • Hypothyroidism
  • Low blood pressure (hypotension)
  • Kidney disease
  • Liver problems
  • Pancreas problems

NOTE: Tell your doctor if you have any of these conditions before taking clozapine.

Specific Concerns About Clozapine And Pregnancy

We need more data to study the effects of clozapine in pregnancy. However, because of the potential risk to your unborn baby, you should not become pregnant while taking clozapine.

This atypical antipsychotic may cause problems with heart and blood vessels in both the mother and child during pregnancy. If you take clozapine while pregnant, your baby might:

  • Be born too early (premature birth)
  • Have low blood pressure (hypotension) or heart problems at birth.
  • Clozapine may also cause the following symptoms in newborns:
  • Trouble breathing, feeding, and/or gaining weight
  • Seizures
  • Jitteriness
  • Muscle stiffness
  • Respiratory distress syndrome

NOTE: If you become pregnant while taking this atypical antipsychotic, stop taking the medication and call your doctor right away. Also, you must discuss with your doctor before taking this antipsychotic if you are breastfeeding or plan on breastfeeding.

Possible Side Effects Of Clozapine

Common Side Effects

  • Drowsiness
  • Restlessness
  • Agitation
  • Anxiety
  • Nausea and vomiting
  • Diarrhea or constipation
  • Weight gain or loss
  • Dry mouth

Serious Side Effects

Atypical Antipsychotics, such as clozapine, shoots a risk for increased blood sugar levels and diabetes.

  • Your doctor should monitor your glucose while you are taking this antipsychotic.

In some cases, clozapine can lead to potentially fatal heart problems or seizures when taken with other drugs that also increase the risk of these conditions.

  • You must discuss all medications you take with your doctor before starting treatment with this antipsychotic.

Other Serious Side Effects

  • Low white blood cell count (leukopenia)
  • Seizures (convulsions, tonic-clonic seizures, atonic seizures, myoclonic seizures)
  • Serotonin syndrome (a rare but serious condition that can occur when you take certain medications with this antipsychotic)

NOTE: Clozapine should be used only after trying other medications that have been proven to reduce symptoms. But are unlikely to cause such dangerous side effects. There is also an increased risk of death associated with the use of this antipsychotic in elderly patients with dementia-related psychosis.

Risks For Taking Clozapine For Long Periods Of Time

There is an increased risk of seizures and death associated with clozapine.

  • You must discuss the risks and benefits of taking clozapine for long periods before starting treatment.

Clozapine brings a small increased risk of certain eye problems, including dry eyes or decreased vision.

  • You should have your eyes checked regularly while taking this antipsychotic.

NOTE: There is an increased risk of suicidal thoughts and behavior in children, adolescents, and young adults taking antidepressants for a long time. Your doctor should monitor for worsening depression or suicidality, especially during the first few months of a course of drug therapy, or at times of dose changes.

Medications That May Interact With Clozapine

clozapine molecular formula

Make sure to tell your doctor about all medications you are taking before beginning treatment with antipsychotic medication, including over-the-counter medications and supplements.

Some medications that may interact with clozapine include:

  • Other antipsychotic medications
  • Tricyclic antidepressants (amitriptyline, desipramine, doxepin)
  • Certain types of antibiotics (erythromycin, clarithromycin)
  • Serotonergic drugs (buspirone, fluoxetine, MDMA [ecstasy], triptans), lithium

NOTE: You should tell your doctor if you are using any other medications, including over-the-counter drugs, supplements, and herbal products.

How Long Does It Take For Clozapine To Work?

For most people, it takes a few weeks before they feel the full benefits of clozapine. However, for some individuals, it can take longer to see improvement in your symptoms and how well your body is responding to this medication.


Clozapine is an effective medication for treating schizophrenia and other psychotic disorders. Especially the use of older antipsychotic medications has not been successful in reducing symptoms. It is also helpful to treat the schizoaffective disorder and some cases of bipolar disorder.

Clozapine should only be taken after trying one or more other medications that are effective but are less likely to cause dangerous side effects. There is also an increased risk of death associated with the use of this antipsychotic in elderly patients with dementia-related psychosis. Be sure to discuss all potential risks and benefits of taking this medication before starting treatment.

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