Latest research on Clozapine

A tricylic dibenzodiazepine, classified as an atypical antipsychotic agent. It binds several types of central nervous system receptors, and displays a unique pharmacological profile. Clozapine is a serotonin antagonist, with strong binding to 5-HT 2A/2C receptor subtype. It also displays strong affinity to several dopaminergic receptors, but shows only weak antagonism at the dopamine D2 receptor, a receptor commonly thought to modulate neuroleptic activity. Agranulocytosis is a major adverse effect associated with administration of this agent. [PubChem]

Latest findings

Antiepileptic medication can reduce epileptic EEG patterns (Duncan, 1987) and so might lead to the underestimation of EEG abnormalities, while Clozapine is known to be the most proconvulsive medication and can lead to an overestimation of EEG abnormalities (Welch et al., 1994; Meyer, 2004; Alper et al., 2007). [source, 2016]
Therefore, we also excluded patients taking anticonvulsant medication or the proconvulsant drug Clozapine. [source, 2016]
Concerning medication, three patients were free of any antipsychotic medication, the others received mono- or dual therapy with atypical antipsychotic medication including Amisulpride (n = 2), Olanzapine (n = 11), Clozapine (n = 4), Quetiapine (n = 2), Ziprasidone (n = 1), Risperidone (n = 5), Aripiprazole (n = 2), Paliperidone (n = 3; cp. [source, 2016]
The formation of a complex drug-HSA has been also found to occur with other antipsychotic drugs, such as Clozapine [24], and phenotiazines: tioridazine, Triflupromazine, and Levomepromazine [25,26]. [source, 2016]
Seventy-five patients were taking atypical antipsychotics (Risperidone, Paliperidone, Clozapine, Aripiprazole, Ziprasidone, and/or Quetiapine) at a median Chlorpromazine equivalent dose of 349.20 (277.64) mg/day. [source, 2016]
There are several possible explanations for the lower prevalence of MetS in the study group participants including the high proportion of young participants (25.6% of the study subjects were < 25 years), male participants (66% male), the short mean duration of illness (4.6 years), the inclusion of participants with a first episode of SMI and the low proportions of participants taking FGA and SGA medication (Chlorpromazine 10.2%, Clozapine 8.2% and Olanzapine 3.7%) that are associated with the highest risk for MetS [36]. [source, 2016]
Although genetic and lifestyle factors may also account for abnormal glucose homeostasis and frank diabetes with antipsychotic treatment, it is likely that the low prevalence of diabetes mellitus in this study is due to the underutilization of antipsychotics with a higher liability for diabetes mellitus such as Clozapine, Olanzapine and Quetiapine [40]. [source, 2016]
Another limitation relates to the small numbers of patients taking some individual drugs, resulting in both limited statistical power to detect associations with QTc interval and unfeasibility to test associations between QTc prolongation and some “classical” AP combinations (e.g. those involving Aripiprazole or Clozapine) recommended by evidence-based guidelines [24]. [source, 2016]
In addition, we tested whether use of Haloperidol, Risperidone, Olanzapine, Clozapine, Quetiapine, Paliperidone or Aripiprazole was associated with QTc interval. [source, 2016]
In terms of drug treatments, use of Haloperidol, Clozapine, Quetiapine and Aripiprazole was more frequent in patients treated with AP polypharmacy (Table 1). [source, 2016]