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Re: Schizophrenia - Clozapine » pretty_paints

Posted by yxibow on March 10, 2007, at 14:05:07

In reply to Schizophrenia - Clozapine, posted by pretty_paints on March 8, 2007, at 5:37:51

> Hi
>
> I have a diagnosis of schizophrenia and am currently on 650mg Clozapine. I have put on about 3 stone in weight. I am sedated a lot and I drool and have incontinence at night. However, this is getting less.
>
> I wanted to know anyone with a similar condition. Anyone on a higher or lower dose of Clozapine? How are you finding it?
>
> Please reply!!! Thanks


Clozaril is a hard medication to manage with its side effects though thankfully it usually has few EPS except pseudoparkinsonism I believe.


The sedation is even more than Seroquel usually which is considered the most -- the suggestion before of Provigil might be of help.


Weight gain would be similar to Zyprexa/Seroquel and would be managed similarly, restricted diet to below basal metabolic rate and daily excercise, in general.


Managment of sialorrhea (drooling) with Clozaril is difficult. Anticholinergics are often tried against it, such as glycopyrrolate, scopolamine (Am Fam Physician 2004;69:2628-34), and the milder ones such as Artane. Unfortunately anticholinergics can also block urination to a degree yet the incontinence is still there. Clonidine sometimes can be used. Direct injection of Botox A into the glands can be used but will fade. Various surgical manipulations of the salivary glands can also be of use but of course are a much major intervention.


Incontinence is something that your doctor would have to figure to manage as there would be pitfalls and interactions with your medication, plus management of drooling at the same time.


I am sorry you are experiencing these effects and wish you could take a different neuroleptic for what ails you but it sounds like there was a necessity for Clozaril at least at this moment.


-- best wishes

Jay

 

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