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Clozapine is a prescription atypical antipsychotic used for treatment-resistant schizophrenia and for reducing recurrent suicidal behavior in patients with schizophrenia or schizoaffective disorder who are at chronic risk. Treatment requires baseline and ongoing absolute neutrophil count testing due the risk of severe neutropenia.
read more about clozapine ...The exact mechanism of clozapine is unknown. Its therapeutic activity in schizophrenia is proposed to involve antagonism at dopamine D2 and serotonin 5-HT2A receptors. Clozapine also blocks adrenergic, cholinergic, histamine, and other dopamine and serotonin receptors, which contributes to its clinical and adverse effects.
Clozapine is reserved for patients with schizophrenia who have not responded adequately to standard antipsychotic treatment. It is also used to reduce recurrent suicidal behavior in schizophrenia or schizoaffective disorder when chronic suicide risk is present. Baseline absolute neutrophil count criteria apply before treatment begins.
Treatment starts at 12.5 mg once or twice daily. When tolerated, the total daily dose increases by 25 mg to 50 mg per day toward 150 mg to 225 mg twice daily by the end of two weeks. Later increases are slower. The maximum recommended dose is 450 mg twice daily.
Clozapine carries boxed warnings for severe neutropenia, orthostatic hypotension with bradycardia or syncope, seizures, myocarditis and related cardiac disorders, and increased mortality in elderly patients with dementia-related psychosis. Severe gastrointestinal hypomotility can also lead to obstruction, ischemia, perforation, surgery, or death. Absolute neutrophil counts require regular monitoring.
Clozapine treats treatment-resistant schizophrenia and reduces recurrent suicidal behavior in selected patients with schizophrenia or schizoaffective disorder.
The recommended starting dose is 12.5 mg once or twice daily.
Clozapine can cause severe neutropenia, so absolute neutrophil counts are checked before and during treatment.
The maximum recommended oral dose is 450 mg twice daily.
Clozapine. MedlinePlus. https://medlineplus.gov/druginfo/meds/a691001.html. Date Accessed September 23, 2026.
Clozapine. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK535399/. Date Accessed September 23, 2026.
CLOZARIL (clozapine) tablet. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=90876802-0e3a-44c9-9ff7-1754dfbe736a. Date Accessed September 23, 2026.
DailyMed - CLOZAPINE tablet. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7c748f8a-73ce-4bd3-aa30-9c66657f06ec. Date Accessed September 23, 2026.
FDA Removes Risk Evaluation and Mitigation Strategy (REMS) Program for the Antipsychotic Drug Clozapine. https://www.fda.gov/drugs/drug-safety-and-availability/fda-removes-risk-evaluation-and-mitigation-strategy-rems-program-antipsychotic-drug-clozapine. Date Accessed September 23, 2026.