Clozapine: Operation, Precautions And Adverse Effects
One of the main drawbacks of traditional antipsychotic medication is the amount of time it takes to act, as well as its possible adverse effects. However, in the 1950s it was synthesized for the first time clozapine, a well-known atypical antipsychotic today
Throughout this article we will talk about its effectiveness, its way of acting in the body, as well as its advantages and disadvantages, and the precautions that those who consume this drug should take.
Clozapine is a benzodiazepine which is included within the group of atypical antipsychotics. The atypical name is attributed to it because of its differences from the rest of ordinary antipsychotics.
These differences lie in the fact that the former cause much fewer extrapyramidal symptoms and also show great effectiveness in treating both the positive and negative symptoms of schizophrenia.
This medication quickly gained fame due to its advantages over other antipsychotics, including its greater effectiveness. However, despite these advantages, clozapine has a large number of unwanted side effects that affect other functions of the body.
Within its particular history, clozapine was withdrawn from the market in the 1970s when it was linked to a series of cases of death due to agranulocytosis in people taking this drug. However, approximately ten years after its withdrawal and due to its high effectiveness, clozapine was reinstated on the market with the obligation for the manufacturer to carry out hematological controls in order to detect any dangerous side effects.
Due to its toxicity, the administration of clozapine is restricted only to schizophrenia resistant to other antipsychotics, as well as to more severe schizophrenia with significant extrapyramidal symptoms or with suicide attempts and self-harm.
Besides, accompanied by psychological intervention and training in psychosocial skills clozapine has been established as the reference drug in the treatment of childhood schizophrenia.
Despite Its use is not recommended in any case other than the treatment of schizophrenia on very exceptional occasions it is administered to patients who present psychotic symptoms and certain neurological conditions in which psychotic symptoms may also arise.
The form of administration
Clozapine is a medication that is administered orally in both tablet and oral suspension formats. Normally the recommended dose is one or two doses a day, preferably at the same time. Nevertheless, It is essential that the patient follow his or her doctor’s instructions to the letter and ask for advice if you have any questions.
Usually, treatment begins progressively; starting with low doses until the patient’s body accepts the medication. Likewise, the patient must have a weekly check-up during the first four months after the start of treatment; after this period, the tests will be performed once a month.
When the medication reaches its maximum therapeutic effect medication adjustment is necessary so that it does not exceed its effects and thus avoid possible unwanted consequences.
Finally, upon cessation of therapy, it is recommended to withdraw clozapine progressively over one or two weeks. When the medication must be withdrawn immediately, due to some pathology such as leukopenia or a decrease in the number of leukocytes in the blood, exhaustive monitoring of the patient’s symptoms is essential.
First of all, it is necessary to ensure that the patient is not allergic to clozapine or any of the compounds it contains. Likewise, the patient should inform their doctor if they take any medication, vitamin supplements or herbal compounds, especially in the case of St. John’s wort.
On the other hand, there are a series of special conditions that must be taken into account before administering clozapine. These conditions are related to a series of conditions and syndromes that could be incompatible with this drug
1. Heart failure
Patients with serious cardiovascular conditions should be especially careful if they take clozapine, since can cause hypotension caused by hemodynamic changes
2. Diabetes
Clozapine may alter blood glucose levels so diabetic people must have particular control.
3. Chronic respiratory conditions
All patients taking clozapine who suffer from asthma or obstructive pulmonary disease should know that this medication can promote the appearance of depressant effects on respiratory function
4. Epilepsy
Neuropathic medications can reduce the seizure threshold, causing a risk of seizures
5. Depression
Clozapine is characterized by exerting a depressant effect on the central nervous system, so People with depression should pay special attention to their symptoms
6. Liver failure
Most of clozapine is metabolized by the liver. Therefore, it is advisable adjust doses to level of liver function
8. Parkinsonism
Although the incidence of clozapine’s effects 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 can cause complications in constipation, causing intestinal obstruction and paralytic ileus.
In addition to enhancing health alterations that are already present before taking the drug. For example, clozapine can increase photosensitivity so it is advisable to avoid continuous exposure to the sun.
Besides, there is a risk of neuroleptic malignant syndrome, a life-threatening condition linked to antipsychotic use. If the person notices symptoms such as fever, tachycardia or altered consciousness, without a justifiable cause, pharmacological therapy should be suspended.
Finally, it is totally inadvisable when handling or driving heavy or dangerous machinery due to the possible appearance of drowsiness or dizziness. In the same way, those people who are regularly 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 may appear?
Among the unwanted side effects associated with clozapine we can find those that appear frequently, those that appear infrequently, and those that appear rarely.
