Clozapine
First Atypical antipsychotic and is Drug of Choice in RESISTANT Schizophrenia
Low D2 Affinity [Lack of Extrapyramidal S/E]and Strong D4 Affinity
Antagonist of 5HT2A, D1, D3 and Alpha-adrenergic receptor
Preferred Antipsychotic in patient who with EPM side effects including tardive dyskinesia
S/E – Sedation, Syncope, hypotension, tachycardia, Nausea & Vomiting, Weight Gain [Highest], constipation, sialorrhea [Hypersalivation], agranulocytosis, myocarditis, seizures [Dose Dependent]
WBC count monitored regularly [Stop if WBC < 3000/mm3 or Neutrophils <1500/mm3]
Should not be started if WBC Count < 3500/mm3.
Should not be started with Carbamazepine as both are bone marrow suppressants