Is changing of Clozapine advisable when treating resistant schizophrenia?

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Posted on Wed, 17 Jun 2015 in Mental Health
Question: What options does my consultant have when changing my medication.
doctor
Answered by Dr. Shubham Mehta 2 hours later
Brief Answer:
need some details

Detailed Answer:
Hello
Welcome here.

Since when are you taking clozapine?
Since how long you have schizophrenia?
What other drugs have you tried?

Kindly reply back with answers.
Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shubham Mehta 9 hours later
I have been taking clozapine under a year before that coplixel depot injection for two years. Abilify when I was in hospital after that a heart friendly drug that nearly killed me through heart failure. I have had schizophrenia for 18 years up to my healing in rwanda. Amisulpride and sulpride years ago and Abilify up to my healing. I had another depot injection respiridon which caused severe back pain it was a new drug at that time while I was in hospital
doctor
Answered by Dr. Shubham Mehta 3 hours later
Brief Answer:
clozapine should not be changed unless absolutely necessary.

Detailed Answer:
Thanks for the details.
You have been given abilify, amisulpride, sulpride, risperidone and clopixol depot in past.

You are taking clozapine.
Clozapine is usually a kind of reserve drug used for resistant schizophrenia.
Use of clozapine in your case suggest that you must have had difficult-to-treat schizophrenia symptoms.

Changing from clozapine to another drug may cause relapse of symptoms as schizophrenia is a relapsing disorder.

What I mean to say is, clozapine once started, has to be changed very cautiously or should not be changed.
It needs to be changed when there are intolerable side effects due to drug.

The treatment options while changing from clozapine are to add another antipsychotic drug like risperidone, olanzapine or ziprasidone to clozapine. Gradually increasing the dose of these drugs and decreasing the dose of clozapine while observing for relapse of symptoms.

May I ask the reason why is your consultant considering about change of clozapine?

Hope you are satisfied with my response.

Take care.
Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shubham Mehta 9 hours later
I believe that I have been given schizophrenia through the tablets and injections I said it to the staff when I was in hospital. What legal position am I in and what can i do about it? Do you know anything about the legal side of psychiatry?
doctor
Answered by Dr. Shubham Mehta 7 hours later
Brief Answer:
patient's autonomy has to be respected.

Detailed Answer:
Schizophrenia can not be induced through medicines which you have been taking.

The drugs which you have been prescribed are all antipsychotics and used in treatment of schizophrenia.

It is always the patient's right to know the details of drug being prescribed. It is the responsibility of the doctor to tell the patient and his caretakers, about the nature of illness, effects of drugs and their side effects, duration of treatment needed.

The doctor should document the progress report of patient on every follow up.

The patient's autonomy has to be respected.
The doctor can not force a patient to take any particular medicines. All the treatment has to be done with patient's consent.

However, the laws may vary from country to country.

If you feel there is any breach in above scenarios, you can approach court of law.

Hope this helps.
Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shubham Mehta

Psychiatrist

Practicing since :2008

Answered : 2004 Questions

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