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Question:

My son is 17 years old and has been on Abilify for a while. Two months ago, his psychiatrist added Risperdal, but my son's symptoms did not improved significantly and he still shows sign of occasional aggression and violence. His psychiatrist is thinking of switching him to Clozaril. What are the pros and cons of Clozaril? Are there any alternatives to Clozaril?

Answered by: Thomas Smith

Clozaril (generic: clozapine) is a very effective medication for schizophrenia--the only medication shown to be more effective than other medications for most symptoms.

Because of the potential for certain side effects, however, it is typically used only after a patient has tried at least 2-3 other medications. Clozapine can be sedating and will lead to increased appetite and significant weight gain in many patients. It also can cause allergic-type reactions involving blood cells (diminished white blood cell count) or organs including the heart (myocarditis) or liver (hepatitis). Although extremely rare, these side effects can make the patient very sick, and close monitoring (including frequent blood testing) with regular visits to a psychiatrist is required for patients taking clozapine.