Clozapine and seizure risk: primary or secondary prophylaxis?

Abstract

Clozapine is licensed for treatment-resistant schizophrenia. Clozapine dosage is normally adjusted according to each patient's clinical response and the side-effect profile, but caution is advocated when using clozapine, due to its association with potentially life-threatening side-effects. One such adverse reaction is the risk of seizures. There is much debate as to how to prevent clozapine-induced seizures: some authors recommend primary and some, secondary prophylaxis with antiseizure drugs. This article highlights an interesting case study and explores various factors that must be considered before a decision is made to prescribe anticonvulsant medication.