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Clozapine

In Prevention of Suicide in Patients with Schizophrenia or Schizoaffective Disorder

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Abstract

▴ The atypical antipsychotic agent clozapine is associated with a lower propensity for extrapyramidal symptoms than classical antipsychotic agents.

▴ The pharmacokinetics of clozapine are affected by wide interpatient variability and a potential for drug interactions. Some studies have shown a relationship between plasma concentrations, duration of treatment and antipsychotic clinical response.

▴ Clozapine (mean 274.2 mg/day; n = 490) had a greater preventive effect on suicidality among patients with schizophrenia or schizoaffective disorder at high risk for suicide than olanzapine (mean 16.6 mg/day; n = 490) in a randomised, rater-blinded, multicentre study (p < 0.05; a 22–24% improvement).

▴ Other prospective noncomparative trials of the effects of clozapine on suicidal ideation or attempts endorsed these results, while results from retrospective trials are equivocal.

▴ Clozapine is commonly associated with sedation, hypersalivation, tachycardia, dizziness, constipation and orthostatic hypotension. Agranulocytosis, diabetes mellitus and weight gain may also occur.

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Authors and Affiliations

  1. Adis International Limited, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, Auckland 10, New Zealand

    Antona J. Wagstaff & Caroline M. Perry

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  1. Antona J. Wagstaff
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  2. Caroline M. Perry
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Correspondence to Antona J. Wagstaff.

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Wagstaff, A.J., Perry, C.M. Clozapine. CNS Drugs 17, 273–280 (2003). https://doi.org/10.2165/00023210-200317040-00004

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