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A plain-language summary of the cited sources below. Informational only — not medical advice.
Clozapine is an atypical antipsychotic medication prescribed for treatment-resistant schizophrenia—meaning it's used when someone with schizophrenia hasn't responded to other antipsychotic drugs, or couldn't tolerate them. It works differently from older antipsychotics: it blocks receptors for both dopamine and serotonin in the brain, but its dopamine-blocking effect is weaker than many other drugs in this class. It also affects receptors for noradrenaline, histamine, and acetylcholine, which contributes to both its effectiveness and its side-effect profile. After a dose, clozapine stays active in the body for varying lengths of time—the elimination half-life averages around fourteen hours but can range from roughly eight to twenty-nine hours, and the overall process happens in two phases.
Common side effects your family member may experience include drowsiness or sedation, dizziness, a fast heart rate, constipation, and excessive salivation. These are not dangerous in themselves but can affect daily comfort and function. More serious risks exist and require close monitoring. Clozapine can cause agranulocytosis, a severe drop in white blood cells that leaves the body vulnerable to infection; because of this, regular blood tests are mandatory and the medication cannot be used if someone is unable to have these tests done. Other serious effects include neuroleptic malignant syndrome (a rare but life-threatening reaction), seizures or involuntary muscle jerks, tardive dyskinesia (involuntary movements that may become permanent), and sudden unexplained death.
Clozapine cannot be used in people with a history of drug-induced loss of white blood cells, bone marrow disorders, or certain severe medical conditions. It's contraindicated if your family member has severe kidney, heart, or liver disease, uncontrolled epilepsy, or paralytic ileus. It also can't be given to someone in a comatose state, experiencing circulatory collapse or severe depression of the central nervous system, or intoxicated with alcohol or other drugs. Anyone with a known hypersensitivity to clozapine or any ingredient in the product cannot take it. The need for regular blood monitoring and the seriousness of some potential side effects mean clozapine is reserved for situations where other treatments have not worked.
Schizophrenia Clinical criteria: Treatment Phase: Continuing treatment Treatment criteria: Must be treated by a psychiatrist; OR Must be treated by an authorised medical practitioner, with the agreement of the treating psychiatrist. Patient must have previously received PBS-subsidised therapy with this drug for this condition, AND Patient must have completed at least 18 weeks therapy, AND Patient must be on a clozapine dosage considered stable by a treating psychiatrist, AND The treatment must be under the supervision and direction of a psychiatrist reviewing the patient at regular intervals. A medical practitioner should request a quantity sufficient for up to one month's supply. Up to 5 repeats will be authorised.
“It has weak D2- and D1-receptor blocking activity, but potent noradrenolytic, anticholinergic, antihistaminic and arousal reaction inhibiting effects.”
“Its elimination is biphasic with a mean terminal half-life of approximately fourteen hours (range 7.9 – 29.1 hours).”
A plain-language summary of the cited sources below. Informational only — not medical advice.
Clozapine is an atypical antipsychotic that acts as an antagonist at both serotonin and dopamine receptors, with weak D2- and D1-receptor blocking activity but potent noradrenolytic, anticholinergic, antihistaminic and arousal-inhibiting effects. It is indicated for treatment-resistant schizophrenia in people who are non-responsive to or intolerant of other antipsychotic drugs, and for schizophrenia more broadly. The elimination is biphasic with a mean terminal half-life of approximately fourteen hours (range 7.9–29.1 hours).
Common adverse effects include drowsiness, sedation, dizziness, tachycardia, constipation and hypersalivation. Serious adverse effects include agranulocytosis, neuroleptic malignant syndrome, seizures, convulsions, myoclonic jerks, tardive dyskinesia and sudden unexplained death. Clozapine is contraindicated in patients with a history of drug-induced granulocytopenia or agranulocytosis, bone marrow disorders, patients unable to undergo regular blood tests, circulatory collapse or CNS depression, alcoholic and other toxic psychoses, drug intoxication, comatose conditions, severe renal or cardiac disease (including myocarditis), severe or progressive hepatic disease or hepatic failure, uncontrolled epilepsy, paralytic ileus, and hypersensitivity to clozapine or product components.
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Curated subset. The full adverse-effect list is in the TGA Product Information; click any citation above to open it.