Monday, December 28, 2009

Jumping on the clozapine bandwagon

I am reading more and more media reports extolling the virtues of clozapine as an effective antipsychotic. Clozapine has been around for years, since the 1970s in Europe and the 1990s in North America. It is the first of the second generation of atypical antipsychotics and has been described as the treatment of last resort for people who have not shown improvement on other antipsychotics. The fact that it is off-patent is one reason why it is not more widely used, but only one reason.

Anybody thinking of taking clozapine should think twice before doing so. Begin by resisting the label of "treatment resistant" that is probably being directed at your relative. Treatment resistant simply means that medical science hasn't found out what your relative's problem is, but by golly, they are going to get a drug for whatever ails them, anyway. If your relative's problem is psychospiritual, which I suspect in most cases it is, then no drug is going to fix a mind that is "on strike." (John Nash's words, not mine.)

Antipsychotics, whether first or second generation, don't make anybody well, they simply repress the more outward signs of psychosis, and very often they even fail to do that. In my experience with Chris, clozapine was no more effective than any of the others, it is much harder to withdraw from, and then there is need for regular blood testing to avoid a potentially fatal condition called agranulocytosis, which involves the white blood cell count.

I am always heartened when I hear that people have managed to get off clozapine, even after many years.


  1. What did John Nash mean when he said about the mind being 'on strike', do you think?

  2. I think he might be referring to schizophrenia as a conscious act of rebellion, but I can't be sure. If he is referring to rebellion, then I would assume, as I have in my son's case, that schizophrenia is at some level an escape hatch and it is conscious. It then begs the question, if a person has free will, then doesn't he bear some responsibility for his behavior?


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