Clozapine

Brand names of clozapine

  • Clozaril

Clozapine is a medication that is used to treat psychotic disorders and it works by obstructing the receptors for many neurotransmitters in the brain, including serotonin type-2 receptors, dopamine type-4 receptors, acetylcholine receptors, norepinephrine receptors and histamine receptors. Neurotransmitters are basically chemical substances that are released by the nerves in the brain to send signals to one another. Dissimilar to the conventional anti-psychotic drugs like haloperidol (Haldol) and chlorpromazine (Thorazine) and also the latest anti-psychotic agents like olanzapine (Zyprexa) and risperidone (Risperdal), clozapine only blocks the dopamine type-2 receptors feebly.

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Things you need to tell your physician before taking clozapine

As in the instance of taking any prescription drug for the first time, prior to using clozapine, it is important to tell your physician as well as pharmacist whether you have allergic reactions to this medication, any of its components or any other medicine. In addition, before you start treatment with clozapine, also inform your physician and pharmacist about all the prescription and over-the-counter drugs, herbal products, dietary supplements, and vitamins you are already taking or intend to take.

Prior to taking clozapine, you should also inform your physician regarding your entire medical history, especially if you have ever suffered from or are suffering from any abnormal heartbeat; low or high blood pressure; glaucoma; paralytic ileus (a health condition wherein food does not travel through the intestine); any problem related to the urinary system or prostate (a gland of the male reproductive system); any aliment related to the heart, lung, liver or the kidneys; and/ or if you or any family member is having or has ever had diabetes. In addition, you should tell your physician if it was ever necessary for you to discontinue any medicine for mental ailment owing to its serious side effects.

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Women, who intend to take clozapine for their condition, ought to tell their physician if they are pregnant, particularly if they are in the final stage of pregnancy; if they are planning to get pregnant; or if they are breast feeding. In case any woman taking clozapine becomes pregnant, she should right away contact her physician for advice on what she should do in such a condition. In case any woman has used this medication during the last few months of her pregnancy, it may possibly result in problems in the newborn soon after delivery.

If you have to undergo any type of surgery, counting a dental operation, you should tell your surgeon/ dentist that you are already taking clozapine from before.

People undergoing treatment with the anti-psychotic drug clozapine ought to be aware of the fact that consumption of alcoholic beverages in combination with this medication may enhance their state of drowsiness, a common side effect of this drug. If you use any tobacco product, you should tell your physician about it before you start taking this medication. It may be noted that smoking cigarette may possibly diminish the efficiency of clozapine.

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You also ought to know that undergoing treatment with clozapine may result in hyperglycemia (a rise in the level of your blood sugar) even if you are not suffering from diabetes. In case you already have schizophrenia, the chances are more that you will develop diabetes in comparison to people who do not suffer from this condition. Moreover, using clozapine or any other anti-psychotic drug is likely to augment the risk of developing diabetes. Contact your physician if you experience symptoms like intense thirst, feel very hungry, urinate very frequently, have an unclear vision and/ or suffer from debility while undergoing treatment with clozapine. These are some common symptoms of diabetes.

In case you experience any of the above symptoms, it is extremely essential for you to contact your physician at the earliest because high blood sugar has the aptitude to result in a severe health condition known as ketoacidosis. If ketoacidosis is not treated in its initial stage, this condition may even prove to be fatal. Some of the symptoms associated with this severe medical condition include vomiting, nausea, and dry mouth, a fruit-like odour in the breath, reduced awareness and shortness of breath.

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People with phenylketonuria (also called PKU), a hereditary medical condition wherein the patient needs to follow a special diet to avoid slowing down or retardation of the mental condition, should know that orally disintegrating tablets enclose aspartame that forms phenylalanine.

Usage

Clozapine is an anti-psychotic agent that is used to deal with psychotic disorders, counting schizophrenia. Owing to the concern regarding the side effects of clozapine, especially agranulocytosis, this medication ought to be set aside only for patients who have not responded to the regular medications or patients who have the chances of developing frequent suicidal thought.

How to use clozapine

Clozapine is taken orally either along with food or without it. Alternately, you may also take this medication as per your physician's prescription. In case you are taking orally disintegration tablets, you should be cautious while removing every tablet from the blister pack just before you take your dose. Place the tablet on your tongue and give a few minutes for it to dissolve and, subsequently, swallow it. Orally disintegrating tablets need not be taken with water. Dispose of all such tablets that have been exposed to air earlier owing to damaged packaging or because you did not take them soon after removing them from the blister pack. You should never keep tablets that have been exposed to the air for your subsequent dose. Treatment with clozapine should begin with a low dosage and the dose should be increased gradually with a view to diminish the potential side effects of this medication like drowsiness, dizziness and seizures. It is important that you closely follow the instructions of your physician. The dosage of this medication is dependent on the medical condition of the patient and his/ her response to therapy. As clozapine has the aptitude to result in the reduction in count of white blood cells (leucocytes), you may require taking regular blood tests according to your physician's instructions.

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Since people using clozapine require close monitoring of their condition, they ought to ensure that they keep all their appointments with the laboratory for different tests. In order to obtain the maximum benefits of using clozapine, you ought to take this medication on a regular basis.

You should not discontinue clozapine abruptly and without talking to your physician. If you stop taking this medication all of a sudden, a number of conditions may deteriorate further. Before discontinuing clozapine, you should reduce the dosage of this medication gradually over a period of few weeks. The complete benefits of using clozapine will not be evident immediately, but it may take many weeks before you experience the advantages. Contact your physician if your condition remains the same or deteriorates even after taking clozapine for some weeks.

How clozapine works

An anti-psychotic medication, clozapine works by inhibiting the actions of dopamine, a chemical (neurotransmitter) present in the brain, and, in this way, it helps to put off specific nerve centers in the brain being stimulated excessively. Certain psychiatric problems are believed to be attributable to these nerve centers.

Side effects

Serious:
Common:
Less common:

Possible interactions

Herbal medicines or minerals:
Specific herbal remedies and mineral supplements may interact with clozapine and, hence, they should not be used in conjunction. For instance, use of valerian and kava kava with this medication may make drowsiness worse. As ginseng partly works in the form of a MAO (monoamine oxidase) inhibitor, it is not advisable to use this herb together with clozapine.
Alcohol:
Consumption of alcoholic beverages is strictly prohibited while undergoing treatment with clozapine, because alcohol augments the seductive action of this medication and may even deteriorate the probable detrimental effects on the functioning of the brain as well as blood pressure.
Tobacco smoking:
Smoking tobacco may possibly hasten the removal of clozapine from the body and in such cases the patient may need an enhanced dosage of the medication. Rapid removal of clozapine from the body may diminish the effects of clozapine.
Marijuana smoking:
Smoking marijuana while taking this medication has the potential to enhance drowsiness, augment the chances of worsening psychosis and/ or result in the deterioration of orthostatic hypotension.
Exposure to heat:
People using clozapine should exercise caution when they are exposed to heat, as it may result in fever as well as damage the body's ability to become accustomed to heat.
Occurrence of unrelated illness:
If are undergoing treatment with clozapine, you should ensure that any infection developed by you is treated quickly. In addition, you should also closely monitor the response of the white blood cells (leucocytes) to infections.

Discontinuation

You should not stop taking clozapine suddenly, but it is preferable that you reduce the dose of this medication gradually over a period of two to three weeks before discontinuing it. In case it is necessary to stop taking this medication, it is important for you to keep a cautious eye on the reappearance of the psychotic symptoms.

Storage instructions

Clozapine should always be kept in the container in which it was available. Seal the container tightly and keep it in a place that is not accessible to children. In addition, it is important to always store this medication at room temperature and in a place free from extreme heat and dampness. Never store clozapine in your bathroom, which is mostly damp. If the expiry date of any medication lapses or you do not require a medication any more, discard it in the appropriate and safe manner.

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Comments

From John Doe - 2010
Stay away from this "so called" medication, it will make you feel useless not too mention the endless trips for blood work. Do yourself a favour. DO NOT seek help from a psychiatrist, talk to your friends or family about what really led you too believe you have a mental illness.
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