Everything You Need to Know About Clozapine: A Nurse's Comprehensive Review
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- Опубликовано: 17 фев 2022
- Hey everyone, in this video, I provide a comprehensive review of Clozapine, an atypical antipsychotic medication used to treat schizophrenia. As a nurse, I have worked with many patients who have been prescribed Clozapine and have seen firsthand the potential benefits and side effects of this medication.
Throughout the video, I cover various aspects of Clozapine, including how it is used, the recommended dosages, and the potential side effects. I also discuss the importance of regular blood draws for patients taking Clozapine and the potential dangers of missing a dose.
As a nurse, I understand the importance of having a good understanding of medications, especially those that are frequently prescribed. I hope that this video can serve as a helpful resource for other nurses who are looking to expand their knowledge of Clozapine.
Of course after making the video I realized I left out. . .SEIZURES! Clozaril often causes seizures in patients :(. It's not uncommon for patients taking Clozaril to also be taking Keppra--an anti-seizure medication.
I'm a patient, Clozaril is the first drug that I felt like myself on. Haldol made me pace and not sleep. I was ok with it at first but then I started wanting to die because I couldn't feel. I tried Sereoquil, and Abilify. The seroquil made me have rls. Abilify made me a total manic and I could not stop. Since I started Clozaril (50mg at night), the only side effects I have had are weight gain and I sleep for about 10-12 hours after I take it. I gained the weight by eating after I fall asleep, I get up and eat and go back to bed and don't recall it. Sometimes multiple times a night. I clean up afterwards and I speak to people while I do it. I have no voices, and I don't see things. I don't drool. It's been about 2 years since I started taking it and my ANC has been stable. I sweat buckets if I skip a dose. I get hot easily, which is an improvement over Haldol. I couldn't get warm. I had to request Clozaril, it's a shame how few patients receive this drug. It works and gives you back whatever it is that the other drugs rob us of. I may sleep a lot but I feel normal during the day. If your patient is drooling maybe that 150mg a day range is kinda high. If the person isn't violent try giving to them at bedtime instead of twice a day. I couldn't function if I took this when I woke up. I went from 120lb to 160lb. Then I went down to 135-140. If you have any questions feel free to ask. I live with my brother and to be honest I would be scared to take this in a hospital setting. I'd be okay alone, but I am virtually roofied for 10 hours after my dose. If I was homeless again it would definately be a no go. Oh, and this drug improved my opposite of constipation problem.
Hi my son today he’s taking this medicine hopefully it’s good for him 🥺
@@suzansh8735 For me it has way less side effects, it makes me quite drowsy though.
Hi their pal , my brother has take lots of medications and none of them work , I guess this med is the only one he hasn't tried , he goes outside looks at everyone , thinks they talking about him , depressed, violent when he doesn't get his way , tired and so on ....Will this med help him ? Like it has helped you ? Why do you say you wouldn't take this med in the hospital ? Or alone ?
@@rottweilergino It may help him, I wouldn't take it alone because it makes me sleep deeply for 10 hours.
Hey guys I love the comments and feed back my son have been suffering from acute psychosis for two year's at the age of 12 and he tried six different medications none of them works I'm a little terrified about starting him on this due to the side affects but I'm sick of watching him suffer so this may be the drug for him good luck to everyone who suffers from a mental illness I'm praying for you guys 🙏🏾🙏🏾🙏🏾🙏🏾
I was the one in 300+ that could not take clozaril because of a neutrophil count of 1.2. I am on Zyprexa, thiothixene and still have failed. I have been put into the permanently disabled category even though I don't want to believe it but they say that I can't take the most powerful supposedly medication out there because of that blood count. Until there is something that can work with me that does not lower neutral fills, I will always be in a state of fear no matter how much I tell myself not to fear things, it comes to life in nightmares and other manifestations...
I hope you've at least found a support group of people w/ similar struggles, sorry to hear about the low white blood cell count :(. Did you WBC resolve and was clozaril helpful for you?
I have immense respect for nurses. Doctors...🤔 I understand people want to believe symptoms will ease with meds. But life largely stops. My brother was so medicated he slept 23 out of 24 hours per day. Maybe it is better than being dead. Not sure because I cannot ask him now that he is. Hospitals used to care for people without drugging the life out of them. You need to be really rich to afford a carer companion unless family can do. I miss him every damn day. My parents should not have become parents. I also struggle. Pain & depression. Some people should have their kids adopted out asap.
thanks for sharing Kim, sorry about your bro :(
@@A_Psych_Nurse thank you.
Thank you for the information. My son has a diagnosis of schizophrenia and is considered treatment resistant. Clozapine has been suggested as an alternative to his paliperidone depot.
Good day, my name is Martin and I took clozapine for about a year and a half after being electroshocked. I don't have schizophrenia or any other mental disorder (I know what you may be thinking, people with schizophrenia have a lack of insight of their illness, but I can assure you that that's not my case). I can guarantee that what's being said here is true so clozapine should be kept as a last resort drug. Besides the side effects mention here I want to add the possible development of myocarditis (a kind of heart attack not exactly a heart attack but as deadly as one). There's also the risk of developing diabetes (the same goes for other AP too) due to the induced hiperglycemia that clozapine produces.
Regarding the constipation I like the emphasis that you put over that side effect. It's highly likely that each of us have experience constipation in some moment of our lives but clozapine puts this into another category(in a bad sense). The induced constipation is such that it's like being pregnant with a brick made of stool.
There is also the fact that tobacco halves the bioavailability of clozapine so is something to take into consideration taking into account that many schizophrenics smoke.
There are also a bunch of nasty side effects that a more rare but if you sum all of them together "rare" becomes not that rare.
As I said before I took clozapine and went out of it. And god the rebound insomnia I got while withdrawing was hell I just couldn't sleep even though my body was pretty tired.
I live now with a strange form of trigeminal neuralgia left behind by the clozapine, so in my case it has made my life pretty miserable
Has clozapine any benefits compared to other APs? probably but probably it is also overstated. I guess the fact that has less affinity to D2 like receptors makes it less prone to tardive dyskinesia and EP symptoms.
But I want to stress this out CLOZAPINE is DANGEROUS and will sedate you hard. Resort to other methods if possible only use it as a last resort.
Have a good day all of you. Thks for reading if you arrived this far.
PS: Clozapine (as other APs) will affect the production of sperm in males thus killing your orgasm and sex life.
Beautifully said, thank you for this comment :)
And yes--when you look up side effects in something like clinical pharmacology, it assigns a percentage to the probability one is likely to experience the side effect (and usually the side effects are in ranges, like 1-5% chance). And as you said. . .the list is LOOOOONG, so I often wonder, if you got 100 side effects and each of them has a 1% chance, what exactly is the probability you're going to experience one of them?
thank you again for your insights
This stuff sounds like straight up poison.
Dude this was an awesome video.
Thank you so much for this video. It’s allowing me to know what the usual side effects are that you see in a real life setting. Thank you so much.
Thank you so much for making this video! I find it very helpful as an aspiring psych nurse
You're sick
Great video. Can you make a video talking about restraint with belts and your thoughts about it?
We only used velcro restraints at the hospitals I've worked at.
on second thought they made have used leather straps at this other hospital, but i never saw a restraint belt. We used cloth belts to restrain elderly into their wheel chairs though.
Don't ever look anything up on Google, always consult the physician or the professionals in person! When you go on Google, you are reading across a broad spectrum of input from random people from different walks of life...
Then you must be rich to pay the professionals !
More importantly, don't listen to psychiatrists, they are which doctors.
It should really be required to try more than two before prescribing Clozapine. It should only be used as a last resort.
Agreed! The good news is (well at least in my limited experience working w/ tens of providers here in Colorado), a number of them are tried before resulting to Clozapine.
Also--research shows Clozapine is as efficacious as other antipsychotics IF and ONLY IF other antipsychotics have NOT been tried first AND failed. Thx for watching :)
Why? There is research and experts with the drug who state it's under utilized. My friend who has schizophrenia has a greater than normal risk of death from suicide and car accidents because convential meds are not effective enough. If clozapine can mitigate the above risks then it can warrant the risk of the Clozapine itself, at least with this drug the risks are well known and mostly predictable compared with suicide.
@@darrenmillar2201 I might start by saying it’s a sensitive topic for me now. My cousin has been in the ICU for 40 days after a clozapine overdose, on a ventilator and dialysis and if he survives he will never be the same again. I guess I don’t trust notions like decreased suicide rates. Once it happens to your family statistics seem trivial. I’m sure it’s helpful to many people but I don’t think psychiatrists sufficiently explain the risk associated with taking the drug. My opinion is that other alternatives should be explored and that Clozapine should be used as a last resort, mainly due to how hard it is on the body and how toxic it is. I’m sorry but I won’t be able to have an intelligent debate about this with you because it’s too emotional a topic for me.
These are just my opinions. I know that for many Clozapine is the only drug that works and if there are absolutely no other alternatives then of course Clozapine should be prescribed. And when it does have to be prescribed, diet and lifestyle should also be addressed BEFORE developing diabetes. In my own experience with psychiatrists, the risks that come with meds are never adequately addressed. I don’t really trust or respect experts and psychiatrists that don’t educate their patients and I feel like patients with schizophrenia need extra help in that considering how common memory and cognitive problems can be. I’ve heard in other RUclipss opinions strongly questioning the idea of the drug being under prescribed. Sorry I don’t remember which videos but if you end up doing a deep dive on Clozapine you’ll eventually come across them.
In my original comment, I only meant to say that more than two other drugs should be attempted before jumping to something as toxic as clozapine. When this first happened I spent days researching Clozapine and trying to make sense of research articles studying the drug’s effects. It’s a pretty crazy drug. I’m glad it exists for the people who have no other options but for anyone who does have other options, I think clozapine should be avoided whenever possible.
That said, I don’t want to discourage anyone from taking it if they absolutely need to. And I support anyone who needs it.
Hope I answered your question. And I hope your friend is well. One thing I wish I had known before this happened is that drugs can just kind of stop working or being as effective, and some subtle things can indicate the start of a psychotic break that you might not realize and because psych hospitals can be so traumatizing a person with schizophrenia might not want to admit they’re having problems and things that seem small might be extremely distressing to them. I wish I had had books on understanding schizophrenia and how to address different things. I had no idea my cousin was a suicide risk and now there’s not a single day that I don’t think about how I could have prevented this. Watch out for your friend and try to have regular check in’s. Also, my cousin only had a psychiatrist and no therapist. I really wish he had had a therapist. Anyways, hope that’s helpful to you. Good luck with things. Be well.
@@darrenmillar2201 I wanted to add that your friend is lucky to have you looking out for them. If you haven’t already, you might want to get phone numbers of their other friends and family and social worker, just in case you notice a change in behavior. Also making sure everyone understands the risk of suicide is much higher and that it usually starts with a psychotic break that could seem very small. My cousin’s roommate witnessed a bunch of things that he should have called me about but he didn’t know he should I guess. So make sure everyone knows. I feel like everyone connected to someone with schizophrenia should be more educated about these things. I really wish I had been. Take good care of your friend. 💚
Thank you for the info! What are some side effects on the long run?
weight gain, tardive dyskinesias, seizures, hypersalivation, cardiac arrhythmias, to name a few .
TD is not one of the side effect for Clozapine
What study shows Clozapine is no more effective than other anti-psychs for non treatment resistant schizophrenia? A meta-analysis disagrees and states it's more effective for both positive and negative symptoms for non treatment resistant groups. Adding to this it's one of the few that doesn't tend to aggravate depression.
Can you post the meta-analysis please? I remember reading a number of articles (I think, it's been a while, hopefully not confabulating here) and Clozapine was supposedly as effective as other antipsychotics if other antipsychotics had not been failed.
I owe clozaril my life it brought me back. But it's too harsh to stay on. There's a new machine it looks like an alexa. They prick your finger like a blood sugar test. It takes one drop. This is a big plus if you need to take this med.
And they say its the best
yeah i'm VERY skeptical about clozapine and its "superior efficacy."
@@A_Psych_Nurse These drugs paralyze people.
Scary shit. I got drugged by two psychopaths psychaitrist who committed perjiry and falsified my medical records intentionally and said thr most wild shit ive ever heard about me. In the process of getting anueropsych test then suing rhe living fuck out of them at and that hospital. Drugged with invega as a sane man 6 months of treatment court ordered all becuase they lied to a judge. Went to the ward willingly thats the worst part didnt have to shoulsve never went and just got a second opinion to the bipolar diagnosis which im also not bipolar. Psychology has 0 scientific evidence to back their claims 0 ways to test serotonin and dopamine levels which i imagine every singoe person has levels that vary from person to person. The quote on quote edicated guesses arent so educated and are key word guesses and in my case i got very unlucky because the psychiatrist created a diagnosis about me making shit up about me and then didnt wake me up for the court date that the judge asked me to speak at. Then i found out they said insane shit about me yet i was called the most normal person at the ward not just that a nurse called me the victim to this internet court date bs and then printed papers on how to sue a mental hospital the very job she works at how to sue a psychiatrist and gave me every medical malpractice attorney and lawyer in Michigan pretty much and then a worker said why are you even here to me before the court date and i told her i was petitiomed for paranoia and delusions and then she replied you are not paranoid and you are definalteynot delusional, there are people here who are both you are not one of them. The. Another worker said ahe was gonna put in good word about me which ultimarely failed becuase the psychaitrist for some reason proudly committed perjiry and created a false diagnosis on me. Im pissed off i got drugged and im suing the living fuck out of them and that hospital
Hay que dar la dosis correcta es un gran antipsicótico!!
Is a high resting heart rate dangerous?
I think so. . .perhaps not in and of itself, but over time I would imagine it would wear on the heart tissue/muscle.
My son has major autism aggression,he is 13.we have tried over 10antiphycotic meds, nothing is working.wld this medication be safe for him??plzzzz help I'm in dire staits here
Give him love... not medication...
This might not be the case with your son, but I knew a seven-year-old who had EXTREME behavioral issues. Then his mother was diagnosed with Celiacs and the whole family went on an extremely limited diet to figure out all their dietary stuff . . . and the boy's behavioral issued mostly disappeared. For him, his bad behavior originated in his gut: he was highly intolerant to a lot of the stuff he was eating, but no one figured that out.
Now, as I said, that might not be what's going on with your son, but consider going on an anti-inflammatory diet (no gluten, no dairy) for a month with your son to see if anything changes.
#akathisia
I can never gain any weight, just keep losing weight. I would love to gain a pound a day.
Have a rootbeer float instead ! Miserable drug. Why is something this horrible a last choice to treat anything?
He's pronouncing it wrong!
Hey , ma .. in a coma ... life is great
I'm on 2mg of colozipen for mood stabilization hate taking them make me feel drowsy
Clozaril or clozapine?
They are the same :)
#akathisia en.m.wikipedia.org/wiki/Akathisia