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Dosage and side effects of clozapine

Background

Clozapine has decreased side effects burden compared with conventional antipsychotics which leads to better patient compliance and results in greater effectiveness. The discovering of clozapine has shown that neurological side effects are not obligatory when treating psychosis but there's risk of agranulocytosis and some other side effects (hypersalivation, sedation, weight gain etc.) The mean dose of clozapine differs between Europe and the United States and the side effects are often the limiting factor for doctors when dosing clozapine.

Materials and methods

The sample included 104 in and out patients treated with clozapine. Side-effects (number of leukocytes, sedation, hypersalivation, dry mouth, extrapyramidal symptomatology, blood pressure fall, maculopapular rush, vomiting and weight gain) were identified with the use of clinical examinations and laboratory analyses. The patients' diagnoses were F20 (66%), F22 and F23 (12%), F25 (16%), F31 and F32 (2%), and other (4%). Our investigation has been carried out in three periods: 7 days after the beginning of therapy, after two and after six months since the beginning.

Results

The number of different side effects decreases during the time, also as the frequency of registered side effects. The patients did not report any severe or unexpected side-effects. The mean dose of clozapine is not significantly higher during those six months. The side effects are not limiting factor when dosing clozapine.

Discussion

Clozapine was effective and safe drug for acute and long-term treatment. Patients didn't report any severe or unexpected side effects. According to the published literature, there are side-effects that we should examine also (cardiac events, diabetes, and hyperlipidemia). In view of the results, it is recommended that the treatment with clozapine should be continually evaluated in the future, in order to detect and prevent all side-effects connected with the use of a widespread antipsychotic such as clozapine.

References

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Milosavljevic, M., Kosutic, Z. & Timotijevic, I. Dosage and side effects of clozapine. Ann Gen Psychiatry 5, S80 (2006). https://doi.org/10.1186/1744-859X-5-S1-S80

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  • DOI: https://doi.org/10.1186/1744-859X-5-S1-S80

Keywords

  • Weight Gain
  • Clozapine
  • Cardiac Event
  • Patient Compliance
  • Agranulocytosis