Clozapine: Benefits, Reducing Side Effect Risks, and Alternatives

This is a recorded lecture. It was given at the monthly Psychosis Education Event in January, 2023. The monthly Psychosis Education Event consists of a free lecture on some mental health related topic, followed by an open-forum question/answer session with a psychiatrist and clinical psychologist. It is free of charge and open to the public. If you would like to join, send me a note via askapsychiatrist.info
Clozapine is the most effective medication for schizophrenia. It is the only medication with FDA approval for reducing suicide risk. About 30% of people with schizophrenia do not get significant benefit from standard antipsychotic medication -- yet in that subset of individuals, clozapine is successful in about 50% of cases (the success rate of other antipsychotic medications is about 7% to 14%).
This lecture discusses:
1. Why do some people with schizophrenia-like symptoms not respond to standard, first-line antipsychotic medications?
2. What are the unique advantages of clozapine?
3. What are the most common or worrisome clozapine side effects, and how can their risks be minimized?
4. Are there any alternatives to clozapine?

[@alanspicer500]

Clozapine is the only drug that has fully treated my psychosis I have schizophrenic affective disorder and still suffer from depression I will never stop taking clozapine only issue is discomfort from monthly blood draw you are a cool guy thanks

[@Gtrellis]

You are a saviour in clearly explaining from A to B clozapine. I'm uneducated with an ongoing heart problem issues to deal with, my daughter with mental problems, about to start her treatment with cloza pine. I only understand the cycle of a combustion engine, so thanks for the complete with analogue explanation.

[@Natalie_Coy]

Just found your channel and so glad I did! I am a clinician and appreciate videos/education that go in-depth with the psychopharmacology.

[@George_uh_Glass]

From the bottom of my heart thank you for making this information available. Thank you so much. “Insight can arise where there wasn’t any before”. That gives me hope for my son.

[@shanandbob8311]

Great content. I appreciate the reference to research.

[@unraveledultimatefate]

Greetings, fellow Psychiatist. What is the most prevalent substance that results in individuals presenting to emergency departments with acute psychosis or anxiety? Which substance out of all most commonly represents a significant mental health challenge to a user?, encompassing both recreational substances and classes of prescription drugs? which are the most common priorities, which priority is the 1st place, and which are secondary, or third?

[@estellawip]

How much Lithium will be a good dosage to use to help schizophrenia?

[@sisi2754]

Please make a video about tests What kind of test are recommendable - blood and urinal. what to test , wich Hormons , vitamins insufficiencies , blood sugar heavy metals, Lupus ....? Especially test to make for treatment resistant (Non Dopamin relevant ) psychoses! My dear one was put on many antipsychotics 7 and Cocktails of meds but nothing worked since years, only horrible and life threatening side effects. How to find what causes the Psychose with tests ?

[@YouTube-Management-ShafiqulIT]

❤❤❤

[@sisi2754]

Alternatives for treatment resistant (non Dopaminrelevat) schizophrenia.

[@littlewhitetrees6129]

Hi Dr. my son has been hospitalized 3 times in the past six years. The last hospitalization was in July of 2021. He has been on lithium (now at 1200) and Zyprexa (15 mg). Both of these were reduced in December 2022. He is relatively stable (not manic) yet maintains delusions that are keeping him housebound (he thinks he’s a god and that if he goes out someone is chasing him and wants to kill him). In the past he has tried Latuda, abilify, seroquel, Depakote, Invega with clozapine (though his clozapine levels were always 125 and below-perhaps because he was smoking a lot) so I don’t know if the clozapine ever had a chance to work. He hated the Invega and I too noticed that it took away his personality. Would you suggest trying clozapine again? Unfortunately he likes the Zyprexa and believes he is perfectly healthy and does not see that his delusions are unrealistic and holding him back. I am at a loss. Any suggestions?

[@Fred-Faizi]

Wow…3 times in the past 6 years? This is good news. My son is 6 times within a year and we still havent tried Clozopine and not sure why. He tried zyprexa, seraquel, abilify, lithium but none working. Do you think clozopine is for him? He is 17 years old.

[@DennisBolanos]

Hi Dr. Messamore. In what field did you obtain your bachelor’s degree?

[@AskAPsychiatrist]

I had a double major in biology and chemistry.

[@DennisBolanos]

@@AskAPsychiatrist Oh nice! I’m a BSc student in Chemistry and, eventually, I plan to pursue a PhD in Pharmacology.