Skip to main content
    • Aa
    • Aa

Clozapine: Is Now the Time for More Clinicians to Adopt This Orphan?


ISSUE:Although many patients with schizophrenia fail to respond adequately to trials of 2 or more antipsychotics, utilization of clozapine for these patients remains low, despite recommendations for its use by accepted treatment guidelines. Some experts estimate that 5–10 times more patients could benefit from clozapine than who are now receiving it. Learning how to manage the unique side effect profile of clozapine can potentially remove barriers to prescribing this agent and thus unlock its unique therapeutic efficacy for more patients.

Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1. JP McEvoy , JA Lieberman , TS Stroup , etal. Effectiveness of clozapine versus olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia who did not respond to prior atypical antipsychotic treatment. Am J Psychiatry. 2006; 163(4): 600610.

2. E Hermes , R Rosenheck . Choice of randomization to clozapine versus other second generation antipsychotics in the CATIE schizophrenia trial. J Psychopharmacol. 2012; 26(9): 11941200.

3. J Nielsen , M Dahm , H Lublin , D Taylor . Psychiatrists’ attitude towards and knowledge of clozapine treatment. J Psychopharmacol. 2010; 24(7): 965971.

4. HY Meltzer . Clozapine: balancing safety with superior antipsychotic efficacy. Clin Schizophr Relat Psychoses. 2012; 6(3): 134144.

6. SM Stahl , DA Morrissette , L Citrome , etal. “Meta-guidelines” for the management of patients with schizophrenia. CNS Spectr. 2013; 18(3): 150162.

7. HY Meltzer , L Alphs , AI Green , etal. Clozapine treatment for suicidality in schizophrenia. Arch Gen Psychiatry. 2003; 60(1): 8291.

10. C Frogley , D Taylor , G Dickens , M Picchioni . A systematic review of the evidence of clozapine's anti-aggressive effects. Int J Neuropsychopharmacol. 2012; 15(9): 13511371.

11. MK Krakowski , P Czobor , L Citrome , N Bark , TB Cooper . Atypical antipsychotic agents in the treatment of violent patients with schizophrenia and schizoaffective disorder. Arch Gen Psychiatry. 2006; 63(6): 622629.

15. J Tiihonen , J Lönnqvist , K Wahlbeck , etal. 11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study). Lancet. 2009; 374(9690): 620627.

16. D Cohen , JP Bogers , D van Dijk , B Bakker , PF Schulte . Beyond white blood cell monitoring: screening in the initial phase of clozapine therapy. J Clin Psychiatry. 2012; 73(10): 13071314.

17. J Nielsen , CU Correll , P Manu , JM Kane . Termination of clozapine treatment due to medical reasons: when is it warranted and how can it be avoided? J Clin Psychiatry. 2013; 74(6): 603613.

18. MM Hsieh , JE Everhard , DD Byrd-Holt , JF Tisdale , GP Rodgers . Prevalence of neutropenia in the U.S. population: age, sex, smoking status, and ethnic differences. Ann Intern Med. 2007; 146(7): 486492.

19. S Rajagopal . Clozapine, agranulocytosis, and benign ethnic neutropenia. Postgrad Med J. 2005; 81(959): 545546.

20. P Manu , D Sarpal , O Muir , JM Kane , CU Correll . When can patients with potentially life-threatening adverse effects be rechallenged with clozapine? A systematic review of the published literature. Schizophr Bull. 2012; 134(2–3): 180186.

21. S Sockalingam , C Shammi , G Remington . Treatment of clozapine-induced hypersalivation with ipratropium bromide: a randomized, double-blind, placebo-controlled crossover study. J Clin Psychiatry. 2009; 70(8): 11141119.

22. J Nielsen , JM Meyer . Risk factors for ileus in patients with schizophrenia. Schizophr Bull. 2012; 38(3): 592598.

23. JM Meyer , MA Cummings . Lubiprostone for treatment resistant constipation associated with clozapine use. Acta Psychiatr Scand. 2014; 130(1): 7172.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

CNS Spectrums
  • ISSN: 1092-8529
  • EISSN: 2165-6509
  • URL: /core/journals/cns-spectrums
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Altmetric attention score

Full text views

Total number of HTML views: 10
Total number of PDF views: 58 *
Loading metrics...

Abstract views

Total abstract views: 266 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 21st September 2017. This data will be updated every 24 hours.