BACKGROUND Gastrointestinal side effects are particularly common with clozapine and occur with other antipsychotics, ranging from mild constipation to fatal bowel obstruction and/or ischemia. While this adverse-effect spectrum has been attributed to 'gastrointestinal hypomotility', gastrointestinal transit times in antipsychotic-treated patients have not previously been measured, making this me...

BACKGROUND The treatment of schizophrenic patients who fail to respond to adequate trials of neuroleptic drugs is a major challenge. Clozapine has been one treatment option; however, it is not universally effective and is limited in its use by safety concerns. With the introduction of newer agents, their performance relative to clozapine is of great clinical interest. METHODS The primary obje...

BACKGROUND Clozapine is widely prescribed and, although effective, can cause weight gain and dysglycemia. The dysmetabolic effects of clozapine are thought to be more prevalent in women with this gender on average attaining 17 % higher plasma clozapine concentrations than men. METHODS We investigated the relationship between dose, body mass index (BMI), plasma glucose concentration, and plasm...

OBJECTIVE To describe 3 cases of clozapine toxicity associated with infectious and/or inflammatory processes. CASE SUMMARIES Three patients stable on clozapine therapy prior to a medical hospital admission developed clozapine toxicity. It was suspected that an acute infectious and/or inflammatory process in each patient was related to abrupt mental status changes, onset of sialorrhea, myoclon...

BACKGROUND While the incidence of new-onset diabetes mellitus may be increasing in patients with schizophrenia treated with certain atypical antipsychotic agents, it remains unclear whether atypical agents are directly affecting glucose metabolism or simply increasing known risk factors for diabetes. OBJECTIVE To study the 2 drugs most clearly implicated (clozapine and olanzapine) and risperi...

To the Editor: Clozapine is an exceptionally effective drug for the treatment of schizophrenia,1 but it may occasionally cause myocarditis, typically within 3 weeks of clozapine initiation.2 The effectiveness of clozapine in the individual patient may be manifest before the onset of myocarditis despite its early occurrence, and clozapine withdrawal may lead to rapid deterioration in psychiatric...

OBJECTIVES Patients with schizophrenia treated with clozapine are at risk of acute myocarditis and dilated cardiomyopathy. However, there are no data on the prevalence of subclinical cardiomyopathy or its associations. METHODS 100 consecutive patients with schizophrenia treated with clozapine for >1 year and without a history of cardiac pathology (group 1), 21 controls with a history of schiz...

Rapid clinical deteriorations have been reported after abrupt discontinuation of clozapine. A 42-year-old psychiatric patient presented with ingestion of hand-disinfectant solutions causing transient impairment of his conscious level. His clozapine therapy was discontinued for a short period of time and he developed delirium with normal results of investigations for underlying organic causes. H...

Clozapine is an atypical antipsychotic drug that is approved by the US Food and Drug Administration (FDA) for the treatment of psychotic disorders. Agranulocytosis is a well-established side effect of clozapine; clozapine has also been associated with other blood dyscrasias like leukocytosis, albeit rarely. In this paper, we aim to report a case of possible clozapine-associated leukocytosis in ...

Development of obsessive-compulsive symptoms during clozapine treatment in schizophrenics has been noted in few reports from west. In our cases, three schizophrenic patients resistant to typical antipsychotics developed obsessive-compulsive symptoms during clozapine treatment. Since clozapine is a potent 5-HT(2) receptor blocker, role of serotonergic systems in the development of obsessive-comp...