Clozapine: operation, precautions and side effects

This drug is effective in cases of schizophrenia, but it has many side effects.

One of the main drawbacks of traditional antipsychotic medication is the length of time it takes to work, as well as its potential adverse effects. However, in the 1950s, clozapine, an antipsychotic drug, was first synthesized. clozapine, an atypical antipsychotic that is well known today, was synthesized for the first time in the 1950s..

Throughout this article we will discuss its efficacy, the way it acts in the body, as well as its advantages and disadvantages, and the precautions to be taken by those who take this drug.

What is clozapine?

Clozapine is a benzodiazepine which is included in the group of atypical antipsychotics. The name atypical is attributed to it because of its differences with the rest of the ordinary antipsychotics.

These differences lie in the fact that the former cause far fewer extrapyramidal symptoms and also show great effectiveness in treating both the positive and negative symptomatology of schizophrenia.

This drug quickly gained fame due to its advantages over other antipsychotics, including its greater efficacy. However, despite these advantages, clozapine has a large number of undesirable side effects that affect other bodily functions. affecting other bodily functions.

Within its particular history, clozapine was withdrawn from the market in the 1970s when it was linked to a number of cases of death due to agranulocytosis in people taking this drug. However, approximately ten years after its withdrawal and due to its high efficacy, clozapine was reintroduced on the market with the obligation for the manufacturer to carry out hematological controls in order to detect any dangerous side effects.

In what disorders is it used?

Due to its toxicity, the administration of clozapine is restricted only to schizophrenias resistant to other antipsychotics, as well as to more severe schizophrenias with significant extrapyramidal symptoms or with suicide attempts and self-harm.

In addition, accompanied by psychological intervention and training in psychosocial skillsclozapine has established itself as the drug of choice in the treatment of childhood schizophrenia.

Despite the fact that Its use is not recommended in any case other than the treatment of schizophrenia.On very exceptional occasions, it is administered in patients presenting psychotic symptomatology and certain neurological conditions in which psychotic symptoms may also arise.

The form of administration

Clozapine is a drug that is administered orally either in tablet form or as an oral suspension. The recommended dose is usually one or two doses per day, preferably at the same time of day. However, it is it is essential for the patient to follow his doctor's instructions to the letter and to seek advice and ask for advice if any doubts arise.

Treatment is usually started progressively, beginning with low doses until the patient's body is able to tolerate the medication. Likewise, the patient must have a weekly control during the first four months after the beginning of the treatment, after this period the analytical tests will be carried out once a month.

When the medication reaches its maximum therapeutic effect it is necessary to make an adjustment of the medication so that it is not exceeded in its effects and thus to avoid possible undesired consequences.

Finally, when the cessation of therapy is reached, it is recommended to withdraw clozapine progressively during one or two weeks. When the withdrawal of the drug must be done immediately, due to some pathology such as leukopenia or decrease in the number of leukocytes in the blood, it is essential to closely monitor the patient's symptoms.

What precautions should the patient take?

First of all, it is necessary to make sure that the patient is not allergic to clozapine or to any of the compounds it contains. The patient should also inform his physician if he is taking any medication, vitamin supplements or herbal compounds, especially in the case of St. John's wort.

On the other hand, there are a number of special conditions that should be taken into account before clozapine administration. These conditions are related to a number of conditions and syndromes that could be incompatible with this drug.

1. Heart failure

Patients with severe cardiovascular conditions should be especially careful when taking clozapine, since hypotension caused by hemodynamic changes.

2. Diabetes

Clozapine may alter blood glucose levelsTherefore, diabetics should be particularly vigilant.

3. Chronic respiratory conditions

All those patients taking clozapine who suffer from Asthma or obstructive pulmonary disease should be aware that this medication may favor the appearance of depressive effects on respiratory function.

4. Epilepsy

Neuropathic-type drugs may lower the seizure threshold, resulting in a risk of seizures. a risk of seizures.

5. Depression

Clozapine is known to exert a depressant effect on the central nervous system, so that people with depression should pay special attention to their symptomatology..

6. Hepatic insufficiency

Most clozapine is metabolized by the liver. Therefore, it is advisable to to adjust doses to the level of hepatic function..

8. Parkinsonism

Although the incidence of the effects of clozapine on extrapyramidal effects is much lower than with other types of antipsychotics, it can potentiate them, thus aggravating the disease.

6. Constipation

The anticholinergic action of clozapine may cause constipation complications, leading to intestinal obstruction and paralytic ileus.

Other risks

In addition to potentiating health alterations that are already present before taking the drug. For example, clozapine may increase photosensitivityIt is therefore advisable to avoid continuous exposure to the sun.

In addition, there is a risk of there is also a risk of developing neuroleptic malignant syndromea life-threatening condition related to the use of antipsychotics. If the person notices symptoms such as fever, tachycardia or altered consciousness, without a justifiable cause, drug therapy should be discontinued.

Finally, it is totally inadvisable in handling or driving heavy or dangerous machinery due to the possible occurrence of drowsiness or dizziness. In the same way, those people who are usually exposed to high temperatures should also pay special attention, since clozapine can cause heat stroke or hypothermia, due to the elimination of hypothalamic regulation.

What side effects can appear?

Among the unwanted side effects associated with clozapine we can find those that appear frequently, those that are infrequent and those that appear on rare occasions.

Frequent side effects

• Dizziness.
• Sensation of sleepiness.
• Tachycardia.
• Hypotension.
• constipation
• weight gain.
• Gastrointestinal problems.
• Urinary incontinence.

Infrequent effects

• Disorientation.
• Insomnia.
• Feeling of tiredness.
• tremors
• headache.
• seizures
• Nightmares.
• Hypertension and hypotension.
• Leukopenia.
• Hyperhidrosis.
• Myoclonic tics.

Rare side effects

• Myocardial infarction.
• Impotence.
• Arrhythmias.
• Granulocytopenia.
• Thrombocytopenia.
• Increased blood glucose levels.
• Pulmonary embolisms.
• Glaucoma.