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Side effects of clozapine.

H J Gaertner1, E Fischer, J Hoss

  • 1Psychiatrische Universitätsklinik, Tübingen, Federal Republic of Germany.

Psychopharmacology
|January 1, 1989
PubMed
Summary

Clozapine therapy, while avoiding agranulocytosis, frequently causes side effects like elevated liver enzymes and hypotension. Most treatments were successful, but adverse reactions led to medication changes in 17% of cases.

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Area of Science:

  • Psychiatry
  • Clinical Pharmacology

Background:

  • Clozapine is an effective antipsychotic but associated with side effects.
  • Understanding the incidence of common clozapine-induced adverse events is crucial for patient management.

Purpose of the Study:

  • To estimate the incidence of frequent side effects associated with clozapine therapy.
  • To evaluate the overall success and reasons for discontinuation of clozapine treatment.

Main Methods:

  • Analysis of 391 clozapine treatments in 315 inpatients.
  • Data collected on side effects, treatment duration, dosage, and patient demographics.
  • Comparison between clozapine monotherapy and combination treatments.

Main Results:

  • Elevated liver enzymes occurred in 49% (61% in monotherapy), with a two-fold increase in 20% (31%).
  • Hypotensive dysregulation (25%), increased temperature (4%), leukopenia (2%), and pharmacogenic delirium (8%) were observed.
  • No cases of agranulocytosis were reported. 71% of treatments were successful, with 68% continuing post-discharge.

Conclusions:

  • Clozapine therapy is associated with frequent, generally manageable side effects, notably elevated liver enzymes and hypotension.
  • Adverse reactions necessitated medication changes in 17% of treatments, while ineffectiveness led to changes in 7%.
  • Clozapine remains a valuable treatment option with a low risk of agranulocytosis, but careful monitoring for other adverse events is essential.

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