Clozapine (Denzapine or Clozaril)


Overview: Clozapine, known by the brand names Denzapine and Clozaril, is an antipsychotic of the Atypical class – the most frequently used class of antipsychotics. Clozapine is used to treat Psychosis – predominantly Schizophrenia. Clozapine is often reserved for use when at least two other antipsychotics have failed to improve the symptoms of Schizophrenia. A 2013 study into efficacy of antipsychotics in treating Schizophrenia concluded that Clozapine was the most effective antipsychotic. Clozapine is only available on prescription.


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Key Facts: It will take around four to six weeks for a patient to feel the full benefits of Clozapine. However, anxiety should lessen rapidly upon consumption of the drug. There are some side effects to Clozapine, as mentioned below. Clozapine should be used without interruption – you shouldn’t suddenly stop taking the medicine. The medicine should help control your symptoms.


How do they work?: Antipsychotics cannot help cure mental health conditions, but they are usually effective in reducing and controlling some of the symptoms associated with these conditions. These symptoms can include delusions and hallucinations, disturbed thoughts, agitation, mania and violence. The medication works by blocking the action of dopamine. It is believed psychotic episodes are caused by the brain producing too much of the chemical dopamine. The medication also regulates levels of other chemicals that are responsible for regulating mood – such as noradrenaline and serotonin. It is recommended that Clozapine is used in conjunction with therapy.


Dosage: It is recommended that you take Clozapine at the same time each day. You can take them with or without food, but it is recommended to take the tablets with water, preferably in the evening. Usually, the first few days of treatment will see the patient take just 25mg per day. After a week, the dose is likely to be titrated up. The maximum dose is 900mg per day, the normal dose is anywhere between 200mg and 450mg. Tablets must be taken at different points in the day if the dosage exceeds 200mg. The tablets come in many different strengths to facilitate easy switches. There is no set duration of treatment for Clozapine, with the course differing from patient to patient, dependent on circumstance and symptoms.


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Side Effects

With each box of Clozapine, there will be an information leaflet enclosed. This will provide an exhaustive list of side effects. Side effects from Clozapine can last any length of time from just a few days to permanent changes. It is natural to experience some side effects as your body gets used to the medication.


Common side effects of Clozapine include constipation, bed-wetting, sedation, weight gain, blurred vision, dry mouth and nausea.


Serious side effects include suicidal thinking, chest pain, movement disorders, seizures, jaundice, cardiac arrest, blood clots, abnormally fast heartbeat and tardive dyskinesia. An overdose should be avoided. You should contact your doctor if any of these serious side effects take place.




You should always read the information leaflet that comes with your medication as it will include important information there. You should tell your doctor if you are taking any other medication. You shouldn’t use any other antipsychotic medication with Clozapine. Do not use any antipsychotic with Tricyclic Antidepressants. Don’t take Clozapine with any medicines that affect the bone marrow, some antibiotics, some painkillers and anti-cancer medicines.


Exert caution in taking other medicines with Clozapine – ask your doctor for advice. Just some of the medicines that have been known to react poorly with Clozapine include sleeping pills, painkillers, anticholingernic medicines, blood pressure medicines, any medicine that effects the heart, diuterics, blood clot medicines, epilepsy medicines, Lithium and medicines for HIV and AIDS among others.


You will need to be able and willing to undergo blood tests – as blood tests will need to be performed on a regular (sometimes weekly) basis when a patient uses Clozapine.


Don’t take Clozapine if you have bone marrow depression, epilepsy, alcohol addiction, liver or kidney problems or jaundice.


Exert caution when using Clozapine if you have a low number of white blood cells, convulsions, any heart, liver or kidney disease, glaucoma, constipation, diabetes or have a history of having strokes.


Alcohol acts as a sedative, therefore it is recommended that anyone taking an antipsychotic doesn’t consume alcohol. Combining Clozapine with recreational drugs is also not recommended. Also be careful not to consume excessive amounts of caffeine.


Clozapine is not recommended in pregnancy or the breastfeeding stage. It is believed that Clozapine can cause withdrawal symptoms in breastfed babies.


Other Atypical Antipsychotics: