Related Experiment Video
Updated: Apr 11, 2026

Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
Published on: September 20, 2024
Clozapine for treatment-resistant schizophrenia with epilepsy: A case report
Toru Horinouchi1,2, Mayusa Mito1, Toshiyuki Ishikawa1,3
1Department of Psychiatry and Neurology Hokkaido University Hospital Sapporo Hokkaido Japan.
Background:
Treatment-resistant schizophrenia (TRS) poses a substantial clinical challenge for which clozapine (CLOZ) is the only effective treatment. However, clinicians may hesitate to prescribe CLOZ for TRS patients with epilepsy due to its presence because CLOZ is contraindicated in patients with uncontrolled epilepsy in some countries including Japan.
Case Presentation:
A 36-year-old male with TRS and focal epilepsy underwent CLOZ therapy. CLOZ was initiated at 6.25 mg and gradually titrated to 250 mg over 3 months, achieving a plasma concentration of 449 ng/mL. Psychotic symptoms improved without worsening of seizure frequency or severity. Mild side effects such as drowsiness and drooling were manageable. Long-term video electroencephalography monitoring detected spike-and-wave activity centered in the frontal region, but did not detect any overt epileptic seizures.
Conclusion:
We report a case of TRS with comorbid epilepsy in which CLOZ therapy was both effective and safe.
Related Concept Videos
Psychosis: Goals of Pharmacotherapy
Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
Antiepileptic Drugs: Potassium Channel Activators
Ezogabine has gained approval as an adjunctive treatment...
Psychosis and Antipsychotic Drugs: Overview
Drug Therapy
Antianxiety Medications
Antiepileptic Drugs: Calcium Channel Blockers
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...

