Title:Clozapine Safety, 40 Years Later
Volume: 9
Issue: 3
Author(s): Michele Raja and Silvia Raja
Affiliation:
Keywords:
Clozapine, schizophrenia, side effects, treatment.
Abstract: Clozapine is, and will remain in the coming years, an irreplaceable drug in psychiatry which has elective
indication in treatment-resistant schizophrenia, suicide risk in schizophrenia spectrum disorders, aggressiveness or
violence in psychiatric patients, psychosis in Parkinson’s disease, prevention and treatment of tardive dyskinesia.
Unfortunately, the drug is largely underused for many and serious side effects. Only a good knowledge of these side
effects and of the main strategies to prevent their occurrence or minimize their impact can allow overcoming the underutilization
of this valuable therapy.
The article describes the clinical and epidemiological features of the non-motor side effects of clozapine including blood
dyscrasias, constipation, diabetes, enuresis, fever, hepatitis, hypersalivation, ileus, myocarditis, nephritis, priapism,
seizures, serositis, weight gain and metabolic syndrome. The paper suggests several strategies, supported by scientific
evidence, in the management of these side effects. The neuropsychiatric side effects of clozapine are not discussed in this
review.
