Not true about clozapine is:
Clozapine: It is a DOC for treatment resistant schizophrenia(TRS) TRS is defined as lack of response to 2 antipsychotics (atleast 1 atypical) at adequate dose for atleast 4-6 weeks It has more affinity for D4 receptors , less affinity for D2- [?] minimum EPS. It has anti- suicide propey It is an antipsychotic agent with maximum weight gain propey. Side effects: most common- sedation (due to H1 blocking propey) Sialorrhea Syncope, hypotension, tachycardia, nausea and vomiting Anticholinergic side effects like constipation Three life threatening side effects: Agranulocytosis(Idiosyncratic) Myocarditis Seizures(Dose dependent) Monitoring: TLC and ANC Once a week for first 6 months Once in two weeks for next 6 months Once a month till patient is on clozapine If WBC count falls below 3000/dL or ANC falls below 1500/dL, STOP the clozapine. Contraindications: WBC <3500/dL History of agranulocytosis on clozapine Use of bone marrow suppressants such as carbamazepine.
Should be discontinued, if WBC counts < 3500/dl
Has no anti suicide propey
Should not be used along with carbamazepine
The action is more on D4 receptors than D2 receptors
Schizophrenia Spectrum and Other Psychotic Disorders