Q2) A schizophrenic patient was on chlorpromazine and olanzapine for the past 6 months, with each drug being prescribed for atleast 6 weeks. The patient is still symptomatic. What is next line of management?
A) Haloperidol depot
B) Aripiprazole
C) Risperidone depot
D) Clozapine
#Medicowesome
#Psychiatry
#Pharmacology
Answer to the above question is D) Clozapine.
Explanation: If two drugs are used for schizophrenia and yet no improvement is seen, then Clozapine is used. Clozapine is DOC for resistant schizophrenia.
Some key points of Clozapine:-
1) It is most effective Antipsychotic
2) Clozapine is most toxic Antipsychotic.
3) It causes following special side effects:-
a) Agranulocytosis :
-Therapeutic Drug monitoring (TDM) cannot be done because plasma concentration is not proportional with agranulocytosis
- Hence it is C/I with Carbamazepine.
b) De novo seizure.
c) Myocarditis.
d) Sedation - Most common side effect.
e) Sialorrhea- Wet pillow syndrome.
4) It shows Antisuicidal effect.
That's all!
- Demotional bloke!
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