Clozaril

Specialties Psychiatric

Published

Specializes in Family Nurse Practitioner.

Hi,

Would you take some time and share your experiences, insights and opinions on Clozaril? Thank you in advance, Jules

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Specializes in Psychiatry (PMHNP), Family (FNP).

For some it has been a wonder drug however lots of side effects, weight gain, drooling not to mention the more serious WBC changes. It certainly had its day in the sun and worked when other anti-psychotics did not. Now we have a wider array of 2nd generation anti-psychotics to choose from. Clozaril is never my first pick now when initiating...

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Now that you mention it, I've hardly seen it used since the other atypicals started coming onto the market. It's been years since I've encountered anyone on Clozaril.

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Specializes in psych, addictions, hospice, education.

I've seen it used with patients who had no success with anything else. Also, patients who have been on it awhile are seldom switched if it's working and the side effects aren't hitting them hard.

From what I've read, it's last choice...while it works well for the schizophrenia symptoms, the side effects are very difficult and they aren't ones that happen seldom.

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Specializes in Family Nurse Practitioner.

I have limited experience with it long term but have seen incredible results in two patients that were very sick and had little to no relief from medications prior to starting Clozaril. Is it practical to hope it can be a long term therapy?

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Specializes in psych, addictions, hospice, education.

Once started on it, it is usually continued unless the side effects are too intense, especially the blood dyscrasias....

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Specializes in Hospice, corrections, psychiatry, rehab, LTC.

In the prison system in which I work, inmates on Clozaril have to have blood work done every 14 days. It is used only as a last resort, because of the potential side effects. Some patients do well on it, others not so well.

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Specializes in psych, addictions, hospice, education.

right...blood tests at least every month, once stable...at LEAST!

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Specializes in Telemetry, LTC, Psych.

works decent for some. bad side effects sometimes.

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Specializes in Med-Surg/Oncology, Psych.

When folks are on our unit, a WBC is done every week. Can someone explain why Clozaril does such a number on the WBC and how its mechanism is different from other atypicals? Thanks!

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Specializes in psych, addictions, hospice, education.

The reason Clozaril can cause agranulocytosis isn't clear. Some believe one of its metabolites is toxic to neutrophils.

http://jpet.aspetjournals.org/cgi/content/abstract/283/3/1375

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Specializes in Psychiatric.

We have about 15 people still on Clozaril at our clinic, and we started a guy on it about 7 months ago...mind you we've tried EVERYTHING on him and nothing was working...Clozaril seems to be working fairly well so far.

We did have to take one fellow off after his WBCs and neuts tanked...he's doing very well on a Zyprexa/Haldol combo though.:up:

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