2016 issue 4


Volume 32, issue 4

Review article

Is clozapine a safe drug? A review of studies concerning complications and adverse side effects in the course of treatment with clozapine

Magdalena Frankowska1, Marta Włodarczyk1, Jan Jaracz1
1. Klinika Psychiatrii Dorosłych Uniwersytetu Medycznego im. K. Marcinkowskiego w Poznaniu
Farmakoterapia w Psychiatrii i Neurologii 2016, 32 (4), 239–254
Date of publication: 15-03-2017
DOI: http://dx.medra.org/10.17393/fpn.2017.02.002
Keywords: clozapine, complications, side effects


Clozapine is considered to be the precursor of second generation antipsychotics. It was introduced to pharmacotherapy of schizophrenia in 1970s. Subsequently, due to several cases of agranulocytosis clozapine was withdrawn from the market. However, evidence suggesting better efficacy of clozapine, in comparison to other antipsychotics, led to reintroduction of this medication. The obligatory monitoring of white blood cell (WBC) count and absolute neutrophil count (ANC) significantly reduced the risk of agranulocytosis. Currently, clozapine is frequently used particularly in schizophrenic patients, who did not respond to other antipsychotics. Benefits related to its use may be interfered due to side effects including also life threating complications. The aim of this review is to present recent data regarding the prevalence, and the management of common side effects of clozapine. Life threating complications like agranulocytosis, myocarditis, thromboembolism and metabolic side effects including weight gain and diabetes observed during treatment with clozapine are discussed in details. Finally the list of very rare side effects of clozapine was presented.

Address for correspondence:
Jan Jaracz
Klinika Psychiatrii Dorosłych Uniwersytetu Medycznego w Poznaniu
ul. Szpitalna 27/33,
60-572 Poznań
phone: +48 61 8 491 531,
email: jjjaracz@gmail.com