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No. 4 (2025)

DISCUSSION

Clozapine: Therapeutic Potential and Possibilities of Reducing Therapeutic Risks

https://doi.org/10.48612/psyph/d8t8-1aak-2gv3

Published 2025-12-30

  • Yu.P. Sivolap
    • ,
  • A.A. Portnova

Yu.P. Sivolap
Peoples’ Friendship University of Russia named after Patrice Lumumba

A.A. Portnova
Scientific and practical center of child psychoneurology

Abstract

Antipsychotics are indispensable in the treatment of schizophrenia and, along with mood stabilizers, play an important role in the treatment of bipolar disorder. A special role in psychopharmacology belongs to clozapine, the first second-generation antipsychotic, which surpasses any other psychopharmacological agents in the treatment of therapeutically resistant schizophrenia and in reducing the risk of suicide in patients with schizophrenia spectrum disorders. Along with the outstanding therapeutic capabilities of clozapine, its use is associated with a high probability of side effects and serious, including fatal, complications of therapy, the most dangerous of which is agranulocytosis. The high therapeutic potential of clozapine, combined with the possible risks of adverse effects, determines the need to consider the simultaneous use of clozapine with other antipsychotics, including third-generation drugs. A combination of clozapine and cariprazine seems promising from the point of view of both efficacy and safety of two antipsychotics, which differ significantly in their pharmacological profile.

Keywords

schizophrenia, schizophrenic spectrum disorders, bipolar disorder, agranulocytosis, second-generation antipsychotics, third-generation antipsychotics, clozapine, cariprazine

PDF (Русский)

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