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Clozamine, depression. Stopping the dosage recommended?

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Internal Medicine Specialist
Practicing since : 1998
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Hi, My name is XXXXXXX and would like to know the side-effects of Clozamine.
I have been prescribed this medication by my doctor and have been taking it since 2 years now. I had suffered a painful divorce due to which i had gone into a depression. I used to cry a lot and feel sad most of the time. Prior to Clozamine I had been prescribed a different medication (don't remember it's name) which didn't have any effect on my condition and therefore did not see any improvement. Clozamine has been working well for me since the last 2 yrs. I get blood tests done every 6 months and have had no issues regarding my health.
Since, I am about to be re-married, I would like to know
1. Whether i can stop taking this medication as i have been feeling well?
2. If I stop, would there be any side-effects. If yes, what could they be.
3. If I have to continue this medication, then for how long? and what are the side-effects for taking this medication for such a prolonged period.
4. Most importantly, if I continue this medication, what side-effects can it have before, during and after pregnancy on me and my child ?

My details are
Age:32 yrs
Height:5ft 4inches.
Weight: 60 kgs.
Medical history: No prior medical problems. Only the one stated as above.

Please advise.
Kind regards, XXXXXXX
Posted Thu, 26 Apr 2012 in Medicines and Side Effects
Answered by Dr. Jasvinder Singh 25 minutes later

Thanks for posting your query. You mean to say Clozapine which is an antipsychotic drug which is often used in psychiatric disorders like bipolar disease and schizophrenia.

1)     First of all, you cannot stop taking this drug abruptly as it has withdrawal effects. The dose should be tapered off and then stopped by your doctor. Abrupt withdrawal may lead to cholinergic rebound effects and hence you have to stop it after gradual reduction of dosage.

2)     Abrupt stopping may cause restlessness, insomnia, anxiety, confusion, nausea/vomiting, cold sweats, muscular aches and pains and diaphoresis as withdrawal effects.

3)     You don’t have to take this drug life long. You can talk to your doctor and get the dose tapaered off. Major side effects with long term use of this drug include agranuloctosis (an acute condition involving a severe and XXXXXXX leukopenia (lowered white blood cell count), cardiac toxicity, gastrointestinal hypomotility and central nervous system disorders like drowsiness, vertigo, headache, tremors and seizures.

4)     It is a pregnancy category B drug i.e. no adequate and well-controlled studies in pregnant women are available. Taking antipsychotic medication during the last 3 months of pregnancy may cause problems in the newborn, such as withdrawal symptoms, breathing problems, feeding problems, fussiness, tremors, and limp or stiff muscles.

So before planning pregnancy tell your doctor about this drug and then get the dose tapered off. You cannot stop this drug in pregnancy. It has to be done before getting pregnant.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

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