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The role of clozapine in treatment-resistant schizophrenia was established by a 1988 landmark multicenter double blind study [42] in which clozapine (up to 900 mg/d) showed marked benefits compared to chlorpromazine (up to 1800 mg/d) in a group of patients with protracted psychosis who had already shown an inadequate response to at least three ...
Hypersalivation can contribute to drooling if there is an inability to keep the mouth closed or difficulty in swallowing (dysphagia) the excess saliva, which can lead to excessive spitting. Hypersalivation also often precedes emesis (vomiting), where it accompanies nausea (a feeling of needing to vomit).
[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.
And yet for those who take clozapine, REMS requires "weekly blood tests for the first 6 months" on the drug, testing "every 2 weeks for the next 6 months" if tests are normal, and "monthly after ...
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]
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.
Clozapine-induced drooling; Bowel colic; Eye inflammation [28] It is sometimes used as a premedication, especially to reduce respiratory tract secretions in surgery, most commonly by injection. [22] [23] Common side effects include sleepiness, blurred vision, dilated pupils, and dry mouth. [1]
Dr. A. Thomas McLellan, the co-founder of the Treatment Research Institute, echoed that point. “Here’s the problem,” he said. Treatment methods were determined “before anybody really understood the science of addiction. We started off with the wrong model.” For families, the result can be frustrating and an expensive failure.