title: Clozapine safety, 40 years later.
abstract: Clozapine is, and will remain in the coming years, an irreplaceable drug in psychiatry which has elective indication in treatment-resistant schizophrenia, suicide risk in schizophrenia spectrum disorders, aggressiveness or violence in psychiatric patients, psychosis in Parkinson's disease, prevention and treatment of tardive dyskinesia. Unfortunately, the drug is largely underused for many and serious side effects. Only a good knowledge of these side effects and of the main strategies to prevent their occurrence or minimize their impact can allow overcoming the underutilization of this valuable therapy. The article describes the clinical and epidemiological features of the non-motor side effects of clozapine including blood dyscrasias, constipation, diabetes, enuresis, fever, hepatitis, hypersalivation, ileus, myocarditis, nephritis, priapism, seizures, serositis, weight gain and metabolic syndrome. The paper suggests several strategies, supported by scientific evidence, in the management of these side effects. The neuropsychiatric side effects of clozapine are not discussed in this review.
authors.forename: Michele
authors.initials: M
authors.lastname: Raja
authors.affiliation: Prisciano 26, 00136 - Roma, Italy. michele.raja@libero.it.
authors.forename: Silvia
authors.initials: S
authors.lastname: Raja
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects*; D003024:Clozapine / Q000009:adverse effects*; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced; D004569:Electroencephalography / Q000187:drug effects; D006801:Humans; D020738:Leptin / Q000235:genetics; D024821:Metabolic Syndrome / Q000139:chemically induced; D010265:Paraproteinemias / Q000139:chemically induced; D044405:Receptor, Serotonin, 5-HT2C / Q000235:genetics; D012640:Seizures / Q000139:chemically induced; D015430:Weight Gain / Q000187:drug effects
chemical_list: D014150:Antipsychotic Agents; D020738:Leptin; D044405:Receptor, Serotonin, 5-HT2C; D003024:Clozapine