Archive 1995–2023

Clozapine is considered to be the precursor of second generation antipsychotics. It was introduced to pharmacotherapy of schizophrenia in 1970s. Subsequently, due to several cases of agranulocytosis clozapine was withdrawn from the market. However, evidence suggesting better efficacy of clozapine, in comparison to other antipsychotics, led to reintroduction of this medication. The obligatory monitoring of white blood cell (WBC) count and absolute neutrophil count (ANC) significantly reduced the risk of agranulocytosis. Currently, clozapine is frequently used particularly in schizophrenic patients, who did not respond to other antipsychotics. Benefits related to its use may be interfered due to side effects including also life threating complications. The aim of this review is to present recent data regarding the prevalence, and the management of common side effects of clozapine. Life threating complications like agranulocytosis, myocarditis, thromboembolism and metabolic side effects including weight gain and diabetes observed during treatment with clozapine are discussed in details. Finally the list of very rare side effects of clozapine was presented.