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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Jeroen on June 11, 2008, at 17:03:11
DAY 12 clozapine, when does this merde kick in?
sigh, any idea philippa
Posted by Phillipa on June 11, 2008, at 17:11:16
In reply to DAY 12 clozapine, when does this merde kick in?, posted by Jeroen on June 11, 2008, at 17:03:11
Sweetie no but will google it for you Jeroen. Love Phillipa
Posted by Phillipa on June 11, 2008, at 17:22:43
In reply to Re: DAY 12 clozapine, when does this merde kick in? » Jeroen, posted by Phillipa on June 11, 2008, at 17:11:16
Jeroen looks like it take a few weeks to find the right dose but I think it is a good choice for you. See google search. Phillipa
GENERIC NAME: clozapine
BRAND NAME: Clozaril
DRUG CLASS AND MECHANISM: Clozapine is an anti-psychotic medication that works by blocking receptors in the brain for several neurotransmitters (chemicals that nerves use to communicate with each other) including dopamine type 4 receptors, serotonin type 2 receptors, norepinephrine receptors, acetylcholine receptors, and histamine receptors. Unlike traditional anti-psychotic agents, such as chlorpromazine (Thorazine) and haloperidol (Haldol) as well as the newer anti-psychotics, risperidone (Risperdal) and olanzapine (Zyprexa), clozapine only weakly blocks dopamine type 2 receptors.PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 25 and 100 mg.
STORAGE: Tablets should be kept below 30°C (86 °F).
PRESCRIBED FOR: Clozapine is use in the management of psychotic disorders including schizophrenia. Because of concern for the side effect of agranulocytosis (see side effects), clozapine should be reserved for patients who have failed to respond to other standard medications or who are at risk for recurring suicidal behavior.
DOSING: Clozapine is given once, twice, or three times daily. The dose often is increased slowly until the optimal dose is found. The full effects of clozapine may not be seen until several weeks after treatment is begun.
DRUG INTERACTIONS: Risperidone (Risperdal) may cause an increase in the amount of clozapine in the blood. This could lead to an increased risk of side effects from clozapine.
PREGNANCY: There are no adequate studies of clozapine in pregnant women. Studies in animals suggest no important effects on the fetus. Clozapine can be used in pregnancy if the physician feels that it is necessary.
NURSING MOTHERS: Animal studies suggest that clozapine is secreted in breast milk. Therefore, women taking clozapine should not nurse their infants.
SIDE EFFECTS: Clozapine may cause a severe reduction in white blood cell count, a condition known as agranulocytosis, in approximately 1 in 100 patients who take it for at least one year. White blood cells fight infections, and a severe reduction in white blood cells can result in severe infections. If not caught early, agranulocytosis can be fatal. Therefore, the white blood cell count should be measured (with a blood test) prior to starting treatment and regularly (weekly) while patients receive this medication, and for 4 weeks after it is stopped.
Among elderly patients with dementia-related psychosis, treatment with clozapine is associated with an increased risk of death for unclear reasons. Clozapine is not approved for use in dementia-related psychosis.
Seizures have occurred in approximately 1 of every 20 to 30 persons receiving clozapine. Patients receiving higher doses seem to be at higher risk.
Dizziness may occur in 1 of 5 persons taking clozapine. In some cases this may be due to orthostatic hypotension, a marked decrease in blood pressure that occurs when going from a lying or sitting position to a standing position. The drop in blood pressure may lead to loss of consciousness or even cardiac and respiratory arrest. This reaction is more common during the first few weeks of therapy while the dose is increasing, when drug is stopped briefly, or when patients are taking benzodiazepines such as diazepam (Valium) or other anti-psychotic drugs.
The most common side effect of clozapine is drowsiness. Other side effects include increased heart rate, increased salivation, headache, tremor, low blood pressure, and fever. Clozapine has anticholinergic effects that interfere with the function of smooth muscles. This can lead to blurred vision and difficulty urinating (when there is enlargement of the prostate) due to effects on the muscles of the eye and bladder. Clozapine slows the intestine and leads to constipation in approximately 14% of patients. Paralysis of the intestinal muscles can lead to paralytic ileus, a condition in which the intestine stops working.
Clozapine also may cause extrapyramidal effects (sudden, often jerky, involuntary motions of the head, neck, arms, body, or eyes). Like other anti-psychotics, clozapine also may cause tardive dyskinesia (potentially irreversible involuntary movements). The risk of such reactions appears to be lower with clozapine than with older anti-psychotics, perhaps due to its weaker effects on dopamine type 2 receptors.
Although there is no clear link between clozapine and diabetes, patients should be tested during treatment for elevated blood-sugars. Additionally, persons with risk factors for diabetes, including obesity or a family history of diabetes, should have their fasting levels of blood sugar tested before starting treatment and periodically throughout treatment to detect the onset of diabetes. Any patient developing symptoms that suggest diabetes during treatment should be tested for diabetes.
Clozapine is eliminated from the body by enzymes (P450) in the liver. Numerous medications can increase or decrease the activities of these enzymes leading to low (potentially ineffective)or high (potentially toxic) levels of clozapine in the blood. When used with these medications, the dose of clozapine may need to be reduced or increased.
Posted by Phillipa on June 11, 2008, at 17:25:13
In reply to Re: DAY 12 clozapine, when does this merde kick in?, posted by Phillipa on June 11, 2008, at 17:22:43
Dozziness and Salivation most common side effects. Love Phillipa
Posted by Jeroen on June 11, 2008, at 17:36:44
In reply to Re: DAY 12 clozapine, when does this merde kick in?, posted by Phillipa on June 11, 2008, at 17:25:13
its been over a week since i had a blood test
Posted by iforgotmypassword on June 11, 2008, at 18:02:07
In reply to Re: DAY 12 clozapine, when does this merde kick in?, posted by Phillipa on June 11, 2008, at 17:22:43
why wouldn't the effects be immediate?
Posted by Phillipa on June 11, 2008, at 19:08:23
In reply to why would DA receptor blockade need to 'kick in'?, posted by iforgotmypassword on June 11, 2008, at 18:02:07
Which effects? The white count? Takes a while. Weekly blood tests monitor. Jeroen ask your doc why. When was the last count taken this is just day l0 right? Love Phillipa
Posted by yxibow on June 14, 2008, at 4:55:04
In reply to DAY 12 clozapine, when does this merde kick in?, posted by Jeroen on June 11, 2008, at 17:03:11
> DAY 12 clozapine, when does this merde kick in?
>
> sigh, any idea philippa
>
>At least two weeks to a month like most antipsychotics, to appreciate any little change. They are not instant fixes, no medication is.
For me, its not working as well (off label), but even when it was, Seroquel took at least a month to start to do something and three months to notice significant changes.
I know you're going through a real tough time with clozapine, which is not an easy medication to deal with -- blood tests, hypersalivation, fatigue (a lot of atypicals have that, but clozapine is major).I have thought for different reasons to switch to it, but have not been able to get other medications that could potentialy be fatal with clozapine off the list, so I still use Seroquel.
There are at least 3-4 generics and registries of clozapine in the states, federally mandated, so it really means business (americanism), unfortunately.
Je croix que c'est merde a ce moment...
C'est pourquoi cela je suggèrent que vous écriviez un journal intime au lieu de la concentration sur les effets secondaires du clozapine.
Het zou beter kunnen zijn om vooruitgangsnota's te schrijven in plaats van zich het concentreren op bijwerkingen van clozapine
- Bien à toi
- Vriendelijke groeten-- Jay
This is the end of the thread.
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