Clozapine Use in a Movement Disorder Clinic

Clozapine is an effective antipsychotic for Parkinson's disease (PD) that does not worsen motor function and can improve tremor. It is approved for PD psychosis in Europe and Australia.

The aim of this study was to report on the use of clozapine in a movement disorder clinic.

We report on patients monitored during the COVID-19 pandemic in clinic over a 7-month period.

Sixty-five patients were seen, of whom 50 had PD. Thirty-one were treated for psychosis, 18 for refractory tremor and 1 for levodopa dyskinesias. The remainder had psychotic symptoms with dementia with Lewy bodies (n = 2) or other movement disorders. Four had clozapine discontinued because of sedation and 1 for agranulocytosis. Three had clozapine temporarily halted because of granulocytopenia but were rechallenged successfully.

When comparing clozapine use in this clinic as compared with others, we deduce that clozapine is likely significantly underutilized in the United States.