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Clozapine, Clozaril, Leponex, Fazaclo


Clozapine was the first of the atypical antipsychotics to be developed.

Clozapine is the only FDA-approved medication indicated for treatment-resistant schizophrenia and for reducing the risk of suicidal behaviour in patients with schizophrenia.

Clozapine was voluntarily withdrawn by the manufacturer in 1975, after reports of agranulocytosis leading to death in some clozapine-treated patients. It was approved for treatment-resistant schizophrenia when studies demonstrated that clozapine was more effective against treatment-resistant schizophrenia than other antipsychotics


atypical antipsychotic


Side Effects

agitation, agranulocytosis, akathisia, angina, confusion, constipation, diaphoresis, dizziness, drowsiness, dystonia, fever, granulocytopenia, headache, hypersalivation, hypertension, hypotension, insomnia, leukopenia, myocardial infarction, nausea/vomiting, neuroleptic malignant syndrome, neutropenia, nightmares, orthostatic hypotension, priapism, restlessness, salivation, sedation, seizures, sinus tachycardia, ST-T wave changes, tardive dyskinesia, tremor, urinary retention, vertigo, visual impairment, xerostomia,

Drug-Vitamin-Herb Interactions

Negative interactions:

Kava may block dopamine worsening movement disorder side effects, may cause excess sedation.

Phenylalanine may worssen the side effect of tardive dyskinesia associated with antipsychotic medications.

St JohnÕs Wort
St JohnÕs Wort accelerates breakdown of olanzapine (Zyprexa) and clozapine (Clozaril).

St JohnÕs Wort and Dong quai
St JohnÕs Wort and Dong quai can cause sensitivity to sun, adding to the side effects of antipsychotic agents.

Sedative herbs: Kava, Passionflower, Hops, Ashwagandha, Calendula, Catnip, LadyÕs Slipper, Lemon Balm, Sassafras, Skullcap, and Yerba mansa.
Sedative herbs may cause excess sedation when used with antipsychotic agents.

Phenothiazines may increase yohimbe toxicity.

Positive interactions:

Coenzyme Q10
Phenothiazines inhibit enzymes containing CoQ10.

Ginkgo biloba
Ginkgo may help reduce side effects and increase efficacy of antipsychotic medications.

Milk Thistle
Milk Thistle may protect the liver against toxicity caused by phenothiazide drugs.

Vitamin E
Vitamin E may help treat and prevent tardive dyskenisia (a side effect of phenothiazide drugs).




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