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What Are The Side Effects Of Clozapine?

Posted on Fri, 1 Apr 2016

Question: Dear Doctor,
I am XXXXX from Colombo, Srilanka. I contacted you regarding my son few weeks back. We went for a second opinion and was directed to give him Clozapine. Is this drug suitable for him. when we checked this out it indicated that it has several number of side-effects. Please advise.
Thank you
Regards,
XXXX

Answered by Dr. Alexander H. Sheppe (6 hours later)

Brief Answer:
Private Consultation

Detailed Answer:
Hello XXXX. I remember you and your son very well. Let me give you my thoughts on this new situation.

Clozapine would be an appropriate treatment for your son's condition. However, as you correctly point out, the side effect profile of this medication can be significant. It would be very helpful for your son, I believe, but I would make some suggestions first.

Before trying clozapine, I recommend increasing doses of his Risperdal to as high as 4mg twice a day (for a total of 8mg), if he can tolerate it. A higher dose of Risperdal is still easier on his system than clozapine, so a full trial of Risperdal should be attempted.

I might also try Zyprexa, if Risperdal fails, before moving on to clozapine. Zyprexa is a more effective medication than Risperdal, and though it has more side effects than Risperdal, it is still better tolerated than clozapine. Doses as high as 30mg a day of Zyprexa may be needed.

If these two options fail, clozapine would be an effective choice. But I would try these other two options first, if your son was my patient.

Please remember to rate and close this answer if you find it satisfactory.

In the future, for continuity of care, I encourage you to contact me at my private link below. After you ask a direct question it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Alexander H. Sheppe (2 days later)

Dear Doctor,
Thank you for your advise. Now his weight is 74.5kg. He is taking 1000mg of Valparine. If we increase to 2,000mg according to his weight than increasing Risperidon what will happen? Please Advise. The reason we are asking is , we took him out for a day out , in the morning we gave him 600mg of Valparine till 6pm in the evening we couldn't give him any other medicine, but his behaviour was good.
Thank you

Regards
XXXX

Answered by Dr. Alexander H. Sheppe (15 minutes later)

Brief Answer:
Followup

Detailed Answer:
Clinical studies show that Risperdal is more effective at behavioral control compared to Valparine. So, I still recommend increasing Risperdal, as I think this is the most effective way to control his behavior.

Please remember to rate and close this answer if you find it satisfactory.

In the future, for continuity of care, I encourage you to contact me at my private link below. After you ask a direct question it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers

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Above answer was peer-reviewed by : Dr. Sonia Raina