Clozapine-related seizures: experience with 5,629 patients.
We reviewed the incidence, clinical features, and management of all clozapine-related seizures in 5,629 patients monitored by the Clozaril Patient Management System, during the first 6 months after marketing. Seventy-one patients had generalized tonic-clonic seizures yielding a frequency of 1.3%. One patient had myoclonic seizures prior to generalization. Seizures tended to occur at low doses (< 300 mg/d) during the titration phase, and at high doses (> or = 600 mg/d) during the maintenance phase. Patients with a history of seizures or epilepsy were more likely to have seizures soon after initiation of therapy, on low doses. Twenty-nine of 37 patients (78%) who had seizures and were rechallenged with clozapine were able to continue the medication with dose reduction and more-gradual dose titration, or with the addition of an antiepileptic medication.
Pacia
S V
SV
Department of Neurology, New York University School of Medicine, NY.
Devinsky
O
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D003024:Clozapine / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004831:Epilepsies, Myoclonic / Q000139:chemically induced; D004827:Epilepsy / Q000150:complications; D004830:Epilepsy, Tonic-Clonic / Q000139:chemically induced / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012640:Seizures / Q000139:chemically induced* / Q000453:epidemiology; D013997:Time Factors
D003024:Clozapine