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It is also used for the treatment of psychosis in Parkinson's disease. [8] [9] Clozapine is recommended by multiple international treatment guidelines, after resistance to two other antipsychotic medications, and is the only treatment likely to result in improvement if two (or one [10]) other antipsychotic has not had a satisfactory effect.
[149] [150] Clozapine is of benefit to around half of this group although it has the potentially serious side effect of agranulocytosis (lowered white blood cell count) in less than 4% of people. [151] [152] [153] Between 12 and 20 per cent will not respond to clozapine and this group is said to have ultra treatment resistant schizophrenia.
The findings advised the consideration of using a prevention therapy for venous thromboembolism after starting treatment with clozapine, and continuing this for six months. [118] Constipation is three times more likely to occur with the use of clozapine, and severe cases can lead to ileus and bowel ischemia resulting in many fatalities. [ 115 ]
Clozapine (Clozaril), an atypical antipsychotic, fell out of favor due to concerns over drug-induced agranulocytosis. Following research indicating its effectiveness in treatment-resistant schizophrenia and the development of an adverse event monitoring system, clozapine re-emerged as a viable antipsychotic.
Vistaril (hydroxyzine) – an antihistamine for the treatment of itches and irritations, an antiemetic, as a weak analgesic, an opioid potentiator, and as an anxiolytic; Vyvanse (lisdexamfetamine) – a pro-drug stimulant used to treat attention deficit hyperactivity disorder and binge eating disorder; Vyvanse is converted into Dexedrine in vivo
Medications are used to reverse the symptoms of extrapyramidal side effects caused by antipsychotics or other drugs, by either directly or indirectly increasing dopaminergic neurotransmission. The treatment varies by the type of the EPS, but may involve anticholinergic agents such as procyclidine, benztropine, diphenhydramine, and trihexyphenidyl.
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