What is it about?
The aim of this paper was to briefly summarize and provide an update on major clozapine adverse effects, especially focusing on those that are severe and potentially life threatening, even if most of the latter are relatively uncommon.
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Why is it important?
As poor treatment adherence in patients with resistant schizophrenia may increase the risk of psychotic relapse, which may further lead to impaired social and cognitive functioning, psychiatric hospitalizations, suicide risks and increased treatment costs, clozapine adverse effects are a common reason for discontinuing this medication and this is a cause of concern. Therefore, all efforts should be made to monitor and minimize adverse effects, improve their early detection and conduct proper management, also to reduce the risk of people being harmed. This must be done considering that, when clozapine fails, there are no effective therapeutic strategies that can be put in place.
Perspectives
Despite its potentially life-threatening adverse effects which deserve special attention, clozapine remains the gold standard in the treatment of treatment resistant schizophrenia (TRS) with, to date, inimitable results compared with other available antipsychotics. However, regardless of the evidence, clozapine is still underprescribed or utilized too late and this may be due to, but not limited to, blood monitoring because it is often tedious for the patients, and the psychiatrists’ fear of severe adverse effects. Therefore improving our knowledge of clozapine is important to increase the possibility of prescribing it to those in need. Also, improving our knowledge on the adverse effects of clozapine and their management may help to reduce the understandable apprehension of physicians and help them to be more confident when prescribing clozapine.
Professor Domenico De Berardis
ASL Teramo
Read the Original
This page is a summary of: Safety of antipsychotics for the treatment of schizophrenia: a focus on the adverse effects of clozapine, Therapeutic Advances in Drug Safety, February 2018, SAGE Publications,
DOI: 10.1177/2042098618756261.
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