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Topic: Clozapine

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Atypical antipsychotic

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	Clozapine - Wikipedia, the free encyclopedia
		Clozapine is contraindicated in individuals with uncontrolled epilepsy, myeloproliferative disease, or agranulocytosis with prior clozapine treatment.
		Clozapine also carries fl box warnings for seizures, myocarditis, and "other adverse cardiovascular and respiratory effects." Lowering of the seizure threshold may be dose related and slow initial titration of dose may decrease the risk for precipitating seizures.
		The manufacturers of both the brand and generic clozapine are required by the FDA to track white blood cells counts for patients receiving clozapine, and pharmacies are required to obtain a copy of the CBC prior to dispensing the medication to the patient.
	en.wikipedia.org /wiki/Clozapine (1403 words)

	Clozapine (Clozaril) Antipsychotics
		Approximately 35 mg of clozapine is equivalent to 100 mg of chlorpromazine (CPZ EQ), the prototype typical antipsychotic.
		Clozapine is a second-line agent for patients who have failed treatment with two or more trials of typical antipsychotics either because of ineffectiveness or intolerable adverse effects.
		Clozapine is rapidly and extensively distributed; it crosses the blood-brain barrier and is distributed into breast milk.
	www.rockford.uic.edu /jc/clozapin.htm (541 words)

	Reference.com/Encyclopedia/Clozapine
		Clozapine is the only FDA approved medication indicated for treatment-resistant schizophrenia and for reducing the risk of suicidal behaviour in patients with schizophrenia.
		Clozapine is yellow crystalline solid with melting point 183-184 °C. It is insoluble in water, soluble in acetone, very well soluble in chloroform.
		Compared to typical antipsychotics, with their strong affinity for D2 receptors, clozapine has a relatively low affinity (about 100X less than haloperidol) for the D2 receptor subtype, and this difference in affinity (more specifically the fast dissociation constant that results in lower affinity) is theorized to be responsible for the "atypicality" of clozapine.
	www.reference.com /browse/wiki/Clozapine (887 words)

	Clozapine Information from Drugs.com
		Clozapine is used to treat the symptoms of schizophrenia including hallucinations, delusions, and confusion.
		Clozapine is in the FDA pregnancy B. This means that it is not expect to be harmful to an unborn baby.
		Clozapine may increase the side effects of other drugs that affect the central nervous system, including antidepressants, alcohol, antihistamines, sedatives (medicines that treat insomnia), pain relievers, anxiety medicines, muscle relaxants, and any others.
	www.drugs.com /clozapine.html (1593 words)

	clozapine
		Clozapine begins to relieve agitation within a few days, helps control mood changes in about 2 weeks, and help difficulties in thoughts and awareness in 6- 8 weeks; hallucinations will decrease in intensity and frequency over 2- 8 weeks.
		After taking Clozapine for 6 months, individuals are no longer considered at serious risk for agranulocytosis and may have the blood work done, and may be given prescription for two weeks at a time.
		Because clozapine can change the effect of other medication, or may be affected by other medication, always check with your doctor or pharmacist before taking other drugs, including over- the -counter medication such as cold remedies.
	twilightbridge.com /psychiatryproper/patientinfosheets/clozapine.htm (1186 words)

	CLOZAPINE
		Clozapine use is associated with a very low incidence of extrapyramidal symptoms.
		Studies of clozapine in the UK in institutionalised patients with moderate to severe schizophrenia and patients with resistant schizophrenia have shown clozapine treatment to be cost effective.
		Clozapine is a useful treatment for schizophrenia in patients unresponsive to or intolerant of conventional neuroleptics.
	www.keele.ac.uk /depts/mm/MTRAC/ProductInfo/summaries/C/CLOZAPINEs.html (1019 words)

	Clozapine for schizophrenia - [Medication]
		Clozapine is used to treat the symptoms of schizophrenia.
		Clozapine is an effective treatment for symptoms of schizophrenia and may reduce symptoms that have not been controlled by other medications.
		Because clozapine does not have some of the bothersome side effects of the older antipsychotic medications, people with schizophrenia may be more likely to take it regularly.
	www.peacehealth.org /kbase/topic/detail/drug/aa47363/detail.htm (473 words)

	Parkinsn's List Drug DataBase clozapine / Clozaril
		Clozapine lowers the seizure threshold and should be used with extreme caution in patients with a history of seizures.
		Clozapine should be used with caution in patients with prostatic hypertrophy, closed-angle glaucoma, or urinary retention because clozapine has strong anticholinergic activity that can exacerbate these conditions.
		Clozapine should be used with caution in the treatment of elderly patients because they are more likely to have problems associated with increased anticholinergic activity, orthostatic hypotension, and CNS depression.
	www.parkinsons-information-exchange-network-online.com /drugdb/036.html (3200 words)

	TREATMENTS FOR SCHIZOPHRENIA
		Clozapine is an 'antipsychotic' or 'neuroleptic' drug, used to treat the symptoms of schizophrenia in people who have not done well on at least two other similar drugs e.g.
		Clozapine tablets should be swallowed whole with at least half a glass of water whilst sitting or standing.
		Clozapine is not, however, a sleeping tablet, although if you take it at night it may help you get to sleep.
	www.nmhct.nhs.uk /pharmacy/dclozapi.htm (2589 words)

	MedlinePlus Drug Information: Clozapine (Systemic) (Site not responding. Last check: 2007-11-07)
		Clozapine (KLOE-za-peen) is used to treat schizophrenia in patients who have not been helped by or are unable to take other medicines.
		Clozapine is available only from pharmacies that agree to participate with your doctor in a plan to monitor your blood tests.
		Clozapine may be more likely to cause side effects in the elderly, including dizziness and fainting, low blood pressure, and confusion or excitement.
	www.nlm.nih.gov /medlineplus/druginfo/uspdi/202157.html (1776 words)

	clozapine (Clozaril) - drug class, medical uses, medication side effects, and drug interactions by MedicineNet.com
		PRESCRIBED FOR: Clozapine is use in the management of psychotic disorders including schizophrenia. Because of concern for the side effect of agranulocytosis (see side effects), clozapine should be reserved for patients who have failed to respond to other standard medications or who are at risk for recurring suicidal behavior.
		Among elderly patients with dementia-related psychosis, treatment with clozapine is associated with an increased risk of death for unclear reasons. Clozapine is not approved for use in dementia-related psychosis.
		Clozapine is eliminated from the body by enzymes (P450) in the liver. Numerous medications can increase or decrease the activities of these enzymes leading to low (potentially ineffective)or high (potentially toxic) levels of clozapine in the blood. When used with these medications, the dose of clozapine may need to be reduced or increased.
	www.medicinenet.com /clozapine/article.htm (765 words)

	Focus on Clozapine
		Clozapine is an atypical anti-psychotic agent whose mode of action is thought to pertain to its interaction with dopaminergic and serotonergic neurotransmitter systems.
		Clozapine was introduced in Europe in 1975.As a result of reports from Finland, where 16 patients out of 2260 exposed (0.7%) developed agranulocytosis and 8 (50%) of them subsequently died from secondary infections, the drug was voluntarily withdrawn from use.
		Clozapine is rapidly distributed; it crosses the blood-brain barrier and is distributed in breast milk.
	www.priory.com /focus14.htm (3105 words)

	Clozapine, Clozaril
		The combination of clozapine and glycine was not effective at decreasing symptoms.
		A subsequent study involving individuals with schizophrenia who were stabilized on clozapine, showed that caffeine avoidance resulted in significantly lower blood levels of the drug.
		Pharmacokinetic interactions of clozapine with selective serotonin reuptake: differential effects of fluvoxamine and paroxetine in a prospective study.
	www.truestarhealth.com /Notes/1122009.html (882 words)

	Clozapine Registry: About Clozapine
		Clozapine is indicated for the treatment of severe schizophrenia in patients who fail standard therapy (see package insert for full prescribing information).
		Although clozapine has proven to be effective for this indication, there are potential serious side effects that require careful medical supervision.
		The IVAX Pharmaceuticals Clozapine Patient Registry will conduct a rechallenge status check with the National Non-Rechallenge Masterfile on all patients new to clozapine, restarting clozapine, or if clozapine experience is unknown prior to issuing an Eligibility Code/Patient ID.
	www.clozapineregistry.com /pages/about.jsp (392 words)

	Recommendation
		Perhaps the best predictor of good outcome in schizophrenia with clozapine is presence of parkinsonian side effects during previous treatment with a standard, typical neuroleptic.¹ Another group that does better is patients with a diagnosis of paranoid-type schizophrenia.
		Although plasma levels are not routinely used to titrate dose, they may be useful if the response is unsatisfactory or if side effects are significant and you want to know if the dose is too high (or too low and the patient is intolerant to an optimal plasma level).
		Clozapine levels over 350 ng/ml are associated with an increased risk of seizures, drowsiness, and slowing on the EEG.(5) About 6% of patients in one study (5) did not achieve clozapine levels over 350 despite 900 mg of clozapine.
	www.mhc.com /Algorithms/Schizophrenia/P16F.htm (550 words)

	Interaction of Dopamine D1 and NMDA Receptors Mediates Acute Clozapine Potentiation of Glutamate EPSPs in Rat ...
		In experiments where clozapine (1 µM) was applied (filled circle), mainly the late EPSP is enhanced; both the integrated area and the half-width were greatly augmented by clozapine.
		The effects of haloperidol and clozapine on extracellular GABA levels in the prefrontal cortex of the rat: an in vivo microdialysis study.
		Daly DA, and Moghaddam B. Actions of clozapine and haloperidol on the extracellular levels of excitatory amino acids in the prefrontal cortex and striatum of conscious rats.
	jn.physiology.org /cgi/content/full/87/5/2324 (7408 words)

	Potentially fatal complications of clozapine therapy: myocarditis, venous thromboembolism and constipation
		Patients taking clozapine who present with flu-like symptoms, dyspnoea, tachycardia, chest pain and other signs and symptoms of heart failure should be investigated for myocarditis with immediate referral to a cardiac unit.
		Clozapine should be withdrawn promptly under the supervision of a psychiatrist if myocarditis or VTE develop, and alternative antipsychotic therapy should be commenced to avoid recurrence of schizophrenia.
		During the six years of the study, 8000 patients started clozapine therapy in Australia and 15 cases of myocarditis and 8 of cardiomyopathy for which there was objective evidence of the diagnosis were reported.
	www.medsafe.govt.nz /Profs/PUarticles/cloz1.htm (1644 words)

	Clozaril Online, Description, Chemistry, Ingredients - Clozapine - RxList Monographs
		(clozapine), the physician should be thoroughly familiar with the details of this prescribing information.
		(clozapine), an atypical antipsychotic drug, is a tricyclic dibenzodiazepine derivative, 8-chloro-11-(4-methyl-1-piperazinyl)-5H-dibenzo [b,e] [1,4] diazepine.
		Active Ingredient: clozapine is a yellow, crystalline powder, very slightly soluble in water.
	www.rxlist.com /cgi/generic3/clozapine.htm (337 words)

	Psych Central - Clozaril (Clozapine)
		Clozapine is a medicine that is used to treat schizophrenia.
		Clozapine is available only from certain pharmacies that participate with your doctor to monitor blood tests.
		Clozapine may cause low blood pressure or dizziness when you stand up too quickly.
	psychcentral.com /meds/clozaril.html (746 words)

	Clozapine - Drugs & Vitamins - Drug Library - DrugDigest
		Clozapine is sometimes also used for the treatment of other severe emotional or mental problems.
		Clozapine is used to help people that have not responded to other medications.
		All patients using clozapine should watch for signs of excessive urination, thirst, and hunger while taking clozapine, which may indicate a high blood sugar level.
	www.drugdigest.org /DD/DVH/Uses/0,3915,168\|Clozapine,00.html (1056 words)

	MedlinePlus Drug Information: Clozapine
		Clozapine is used to treat schizophrenia in patients where other medicine has not worked.
		Clozapine is in a class of medications called antipsychotics.
		The amount of clozapine you take may need to be adjusted, especially during the first few weeks.
	www.nlm.nih.gov /medlineplus/druginfo/medmaster/a691001.html (933 words)

	Clozapine-resistant schizophrenia: a positive approach -- WILLIAMS et al. 181 (3): 184 -- The British Journal of ...
		dose titration with clozapine as monotherapy (James and Gray, 1999).
		Kando, J. C., Tohen, M., Castillo, J., et al (1994) Concurrent use of clozapine and valproate in affective and psychotic disorders.
		Morera, A. L., Barreiro, P. and Cano-Munoz, J. Risperidone and clozapine combination for the treatment of refractory schizophrenia.
	bjp.rcpsych.org /cgi/content/full/181/3/184 (2433 words)

	Clozapine
		If you have any of the following conditions: A history of low white blood cell count with clozapine, seizures that are uncontrolled, bone marrow diseases where not enough blood cells are being made.
		This medicine is used to treat psychosis as seen in schizophrenia, schizoaffective disorder, bipolar disorder, major depression, and dementias.
		Clozapine acts as a mood stabilizer and works on improving social interactions, mood, expression of mood, as well as, delusions, paranoia, and appearance.
	www.umm.edu /altmed/ConsDrugs/Clozapinecd.html (870 words)

	Clozapine - Patient UK
		Clozapine is effective in helping symptoms such as hearing voices, loss of energy, thought disturbances, difficulties communicating with others, worry, depression, overcoming feelings of wanting to be alone as well as other symptoms of schizophrenia.
		It is important that you have regular blood tests while you are being treated with clozapine.
		Clozapine may cause lightheadness and dizziness when getting up from a lying or sitting position, particularly when you begin treatment, getting up slowly should help.
	www.patient.co.uk /showdoc/30003674 (775 words)

	Clozapine - a survey of patient perceptions -- Taylor et al. 24 (12): 450 -- Psychiatric Bulletin
		Clozapine - a survey of patient perceptions -- Taylor et al.
		Clozapine is an established treatment for schizophrenia that
		Clozapine thus remains the drug of choice in treatment-resistant
	pb.rcpsych.org /cgi/content/full/24/12/450 (1233 words)

	Clozapine initiation in the community -- O'Brien and Firn 26 (9): 339 -- Psychiatric Bulletin
		The patient is given 12.5 mg of clozapine.
		The clozapine dose is gradually increased depending on clinical
		ROSENHECK, R., CRAMER, J., XU, W., et al (1997) A comparison of clozapine and haloperidol in hospitalised outpatients with refractory schizophrenia.
	pb.rcpsych.org /cgi/content/full/26/9/339 (1797 words)

	NAMI \| About Medication
		Generic forms of clozapine are marketed by Zenith Goldline and Mylan Pharmaceuticals.
		Clozapine has been shown to reduce suicide in persons with schizophrenia. It is the only antipsychotic medication that has been demonstrated to have this effect to date.
		Clozapine is a unique medicine and has important possible benefits as well as risks. The most noteworthy risk is weight gain and the risk
	www.nami.org /helpline/clozapine.htm (1948 words)

	Management of clozapine-resistant schizophrenia -- Kerwin and Bolonna 11 (2): 101 -- Advances in Psychiatric Treatment
		Kane, J. (1992) Clinical efficacy of clozapine in treatment refractory schizophrenia: an overview.
		Munro, J., Matthiasson, P., Osborne, S., et al (2004) Amisulpride augmentation of clozapine: an open non-randomized study in patients with schizophrenia partially responsive to clozapine.
		Wahlbeck, K., Cheine, M. and Tuisku, K. (2000) Risperidone versus clozapine in treatment-resistant schizophrenia: a randomized pilot study.
	apt.rcpsych.org /cgi/content/full/11/2/101 (2218 words)

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