[Clozapine: an exclusive treatment?].
Clozapine is an atypical antipsychotic drug which must only be prescribed for the treatment resistant schizophrenic patients. Contra-indications and precautionary measures (F.e no use of a drug that can enhance the potential for a granulocytoxic reaction) have to be well known and respected. There is an increased risk of granulocytopenia, and 1 or 2% of granulocytopenia may induce an agranulocytosis. This risk is compared with what is observed with other psychotropic drugs, phenothiazines particularly. Beyond clozapine adverse effects, three cases of severe cardio-vascular and respiratory dysregulation, one case of sudden death, and one case of induced coma are presented in detail from the literature: possible interactions between clozapine and adjunctive medications are discussed. Appropriate patients should be proposed a treatment by clozapine, in principle without association to any other psychotropic drug and in all the necessary precautions.
Vanelle
J M
JM
Service hospitalo-universitaire de Santé Mentale et de Thérapeutique, Hôpital Sainte-Anne, Paris.
D000380:Agranulocytosis / Q000139:chemically induced; D003024:Clozapine / Q000009:adverse effects / Q000627:therapeutic use*; D004357:Drug Synergism; D006402:Hematologic Diseases / Q000139:chemically induced*; D006801:Humans; D009459:Neuroleptic Malignant Syndrome / Q000209:etiology; D012559:Schizophrenia / Q000188:drug therapy*
D003024:Clozapine
Clozapine: traitement exclusif?