Clozapine

Psychiatry

Psychiatry · Atypical antipsychotic

Clozapine

Dose

12.5 mg PO OD day 1, titrate slowly to 200–450 mg/day under registered monitoring service.

Contraindications

  • Previous clozapine-induced neutropenia
  • Severe cardiac disease
  • Paralytic ileus

Use

Treatment-resistant schizophrenia after two adequate antipsychotic trials.

Monitoring

FBC weekly ×18 weeks then fortnightly then monthly; troponin/CRP in first 4 weeks (myocarditis); levels.

Side effects

  • Agranulocytosis
  • Myocarditis/cardiomyopathy
  • Hypersalivation
  • Constipation → ileus
  • Seizures at high dose

Related in WardRound

Always confirm dose against your local formulary / BNF before prescribing.

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