Clozapine: between efficacy and safety

Abstract

© 2015 Psychiatr Psychol Klin. Although clozapine is considered to be an effective antipsychotic agent, it is used less frequently than dictated by its properties and supported by clinical trials. At least 1/3 of schizophrenia patients are treatment-resistant, carry a high risk of suicide or suffer from severe extrapyramidal symptoms related to other antipsychotics. A possible reason for the relative underuse of clozapine in clinical practice is its perception as a drug burdened with serious side effects. Agranulocytosis and other blood dyscrasias are well known, and the principles of prevention are established in recommendations. Other side effects, including potentially dangerous ones, such as cardiomyopathy and myocarditis, intestinal obstruction or convulsions, are less known. These side effects can be prevented, detected and treated provided that clinical vigilance is maintained. The awareness of benefits and risks associated with the use of clozapine is a prerequisite for efficient and safe use of this medication and for taking full advantage of its unique properties.