Role of clozapine

Clozapine is the most effective therapy for treatment-resistant schizophrenia; at least one-third of patients moderately improve after taking clozapine for 6 to 12 months. Clozapine is uniquely effective in reducing suicidality, aggression and problem substance use.

The principal factors limiting clozapine use are its adverse effect profile and patient willingness to take an orally administered drug and adhere with regular monitoring.

A psychiatrist should offer clozapine to an adult or young person if they meet the criteria for treatment-resistant schizophrenia and clozapine is not contraindicated.

The role and use of clozapine in children are beyond the scope of these guidelines.