clozapine / Generic mfg. - LARVOL DELTA

A Case Report: Successful Management of Mixed Tardive Syndrome With Combination Pharmacotherapy in a 19-Year-Old Female With Schizophrenia. (PubMed, Clin Case Rep) - "A 19-year-old female with schizophrenia developed severe mixed tardive syndrome (choreoathetoid dyskinesia with prominent tardive dystonia) after antipsychotic treatment, which remained debilitating despite deutetrabenazine, benzodiazepines, baclofen, and amantadine. Over a 39-day inpatient stay, switching the antipsychotic to clozapine and adding botulinum toxin injections plus the central muscle relaxant eperisone led to dramatic improvement, with the Abnormal Involuntary Movement Scale (AIMS) score falling from 32 to 8...This case illustrates that a multimodal strategy-combining a low-D2-affinity antipsychotic, a VMAT2 inhibitor, and targeted muscle relaxation-was associated with marked improvement in this patient with refractory mixed tardive syndrome. However, given the near-simultaneous implementation of multiple interventions, the relative contribution of each component cannot be definitively determined, and controlled studies are needed to establish the efficacy..."

Journal • CNS Disorders • Dystonia • Movement Disorders • Psychiatry • Schizophrenia

Integrating pharmacovigilance, pharmacokinetics and clinical outcomes in clozapine safety science. (PubMed, BJPsych Bull) - "This editorial argues that integrating these approaches within a coherent clinical framework may improve prediction and individualisation of risk while acknowledging current methodological limitations. Progress may therefore depend less on generating additional isolated evidence than on connecting the data already available."

Adverse events • Clinical data • Journal • PK/PD data • CNS Disorders • Psychiatry • Schizophrenia

Utilization of Long-Acting Injectable Antipsychotics and Clozapine in Coordinated Specialty Care: Data From EPINET. (PubMed, J Clin Psychiatry) - " Pharmacological treatment practices regarding LAIs and clozapine are highly variable in US-based CSC programs. Higher adoption and patient reach through implementation strategies of these evidence-based practices might decrease the all-too-frequent occurrences of persistent positive symptoms, psychotic relapse, and hospitalization in early phase psychotic disorders."

Journal • CNS Disorders • Psychiatry

FULMINANT CLOZAPINE-INDUCED EOSINOPHILIC MYOCARDITIS PRESENTING AS CARDIOGENIC SHOCK WITH RAPID RECOVERY AFTER CORTICOSTEROID THERAPY (CHEST 2026) - No abstract available

Cardiovascular • Inflammation

DISPROPORTIONATE REPORTING OF SERIOUS PNEUMONIA WITH CLOZAPINE COMPARED TO OTHER ATYPICAL ANTIPSYCHOTICS: A DISPROPORTIONALITY ANALYSIS (2016-2026) (CHEST 2026) - No abstract available

CNS Disorders • Infectious Disease • Pneumonia • Respiratory Diseases

Virtual Reality-Assisted Therapy Compared to Cognitive Behavioral Therapy for Patients With Treatment-Resistant Schizophrenia: Assessor-Blind Randomized Controlled Trial. (PubMed, JMIR Ment Health) - "A total of 136 participants were randomly assigned 1:1 to VRT or CBT, stratified by sex and clozapine use status...Improvements were also seen in some secondary outcomes, such as general psychotic symptomatology, and those were similar for both interventions. Overall, these findings support the value of VRT as a personalized and clinically effective intervention."

Clinical • Journal • CNS Disorders • Infectious Disease • Novel Coronavirus Disease • Psychiatry • Schizophrenia

Metformin, but Not Aripiprazole, Was Associated With Attenuation of Weight Gain in Clozapine-Treated Inpatients With Concurrent Disorders: A Repeated Measures Cohort Analysis: La metformine, mais non l'aripiprazole, a été associée à une atténuation du gain de poids chez les patients hospitalisés traités par la clozapine et présentant des troubles concomi (PubMed, Can J Psychiatry) - "Metformin was associated with attenuation of weight gain over time (time × metformin: B = -2.63, 95% CI -4.49 to -0.76), whereas aripiprazole was not (B = -0.38, 95% CI -2.58 to 1.82).ConclusionMetformin was associated with attenuation of weight gain trajectory in this population, whereas aripiprazole showed no clear effect. These findings highlight substantial metabolic vulnerability in inpatient concurrent disorders settings and support early preventive metabolic interventions during clozapine treatment."

Journal • CNS Disorders • Psychiatry • Schizophrenia

The influence of pharmacogenetics on the treatment-related outcomes of antidepressants and antipsychotics in Brazil: a systematic review. (PubMed, Pharmacogenomics) - "In schizophrenia, variants in CYP2C19, DRD1, DRD2, and CYP1A2 were associated with clozapine safety and response...For smoking cessation, CYP2B6 rs2279343 AA showed greater success with bupropion...Therefore, routine pharmacogenetic testing in Brazilian psychiatric practice remains premature. PROSPERO CRD42024533782."

Biomarker • Journal • Review • Bipolar Disorder • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry • Schizophrenia • Tobacco Cessation • CYP1A2 • CYP2C19 • DRD2 • HTR2A

Functional Coupling Between MC4R and Kir7.1 Contributes to Clozapine-Induced Obesity (OBESITY WEEK 2026) - No abstract available

Genetic Disorders • Obesity • MC4R

Effects of Nitraria Retusa Infusion on Clozapine-induced Metabolic Side Effects (clinicaltrials.gov) - P=N/A | N=30 | Recruiting | Sponsor: Faculty of Medicine, Sousse

Adverse events • New trial • CNS Disorders • Genetic Disorders • Obesity • Psychiatry • Schizophrenia

Cytokine and C-reactive protein concentrations over 6 months of treatment with clozapine in treatment resistant schizophrenia. (PubMed, Brain Behav Immun Health) - "Concurrent increases in TNF-α and IL-10 may reflect increased activation of both pro-inflammatory and compensatory anti-inflammatory mechanisms over 6 months of clozapine treatment. Composite indices of inflammatory profile may be advantageous in future studies examining relationships with symptom improvement during clozapine treatment."

Journal • CNS Disorders • Oncology • Psychiatry • Schizophrenia • CRP • CXCL8 • IFNG • IL10 • IL13 • IL2 • IL4 • IL6 • TNFA

Clozapine-Associated Serotonin Syndrome: A Case Report and Literature Review. (PubMed, J Psychiatr Pract) - "We present the case of a 37-year-old male with unspecified psychosis and a structural neurological deficit who developed SS according to the Hunter Criteria while on a regimen of clozapine, paliperidone, and prednisone taper. In addition, clinicians should exercise caution when using clozapine in patients with complex neurological conditions or in those with atypical psychiatric presentations. Close monitoring is needed when clozapine dose adjustments are made."

Journal • Review • Cardiovascular • CNS Disorders • Movement Disorders • Psychiatry

Prevalence of Treatment-Resistant Schizophrenia: A Nationwide Multicenter Study. (PubMed, Neuropsychopharmacol Rep) - "This study had the largest sample size among single-cohort studies investigating the prevalence of TRS. The prevalence of TRS was 28.6% among patients with schizophrenia who underwent a TRS examination and was nearly identical to the pooled prevalence reported in studies at low risk of bias in a previous meta-analysis. These findings may provide important evidence regarding the prevalence of TRS in routine clinical practice."

Clinical • Journal • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Psychiatry • Schizophrenia

Autism Spectrum Disorder, Temporal Lobe Epilepsy, and Treatment-Resistant Schizophrenia With Media-Themed Delusions and Impaired Insight: A Case Report. (PubMed, Case Rep Psychiatry) - "Treatment with clozapine has provided partial control of his psychotic symptoms, while sodium valproate has effectively managed his epilepsy. This case highlights the clinical intricacies associated with the coexistence of ASD, epilepsy, and TRS, underscoring the need for patient-specific, multidisciplinary approaches to diagnosis and long-term management."

Journal • Autism Spectrum Disorder • CNS Disorders • Epilepsy • Genetic Disorders • Psychiatry • Schizophrenia

Treatment-resistant Parkinson's disease psychosis responding to xanomeline-trospium: A case report. (PubMed, Clin Park Relat Disord) - "He was referred specifically for a trial of clozapine therapy, which the patient and caregiver declined due to its risk profile. The patient's psychosis proved refractory to three pharmacologically distinct therapies-quetiapine, a low-affinity, rapidly dissociating dopamine D2 receptor antagonist; brexpiprazole, a dopamine D2 partial agonist; and pimavanserin, a selective 5-HT2A receptor inverse agonist-before improving with xanomeline-trospium, whose antipsychotic effects are mediated through central M1/M4 muscarinic receptor agonism. This case supports the further investigation of muscarinic receptor agonism as a therapeutic strategy for Parkinson's disease psychosis."

Journal • CNS Disorders • Movement Disorders • Parkinson's Disease • Psychiatry • DRD2

GLP-1 (Glucagon-Like Peptide-1) and GIP (Glucose-Dependent Insulinotropic Polypeptide)/GLP-1 Receptor Agonists for Antipsychotic-Induced Weight Gain: A Narrative Review. (PubMed, Cureus) - "The clinical management of severe mental illness faces a profound longevity crisis, as second-generation antipsychotics, particularly clozapine and olanzapine, trigger severe weight gain and cardiometabolic complications that reduce life expectancy by 10 to 20 years. Traditional lifestyle modifications and metformin frequently fail because they do not address the hypothalamic disruption and altered reward signaling caused by these medications...Although large-scale randomized controlled trials for tirzepatide in severe mental illness are still limited, preliminary data underscore its extensive role as a comprehensive metabolic stabilizer. Ultimately, closing the mortality gap in psychiatry requires a transition from reactive rescue models toward early, proactive metabolic protection at the onset of antipsychotic therapy."

Journal • Review • Cardiovascular • CNS Disorders • Psychiatry

Health-Related Quality of Life Among Patients with Treatment-Resistant Schizophrenia Receiving Clozapine-Based Therapy in South Kalimantan, Indonesia. (PubMed, Patient Prefer Adherence) - "Treatment regimen remained associated with both HRQoL measures after adjustment. These findings represent associations rather than causal effects and support individualized treatment selection, monitoring of treatment burden, and integration of psychosocial interventions."

HEOR • Journal • CNS Disorders • Depression • Mood Disorders • Psychiatry • Schizophrenia

Clozapine-induced inflammation: a case report. (PubMed, Front Psychiatry) - "The inflammatory response resolved promptly after dose reduction and did not recur with a slower titration schedule and lower maintenance dose. This case highlights the importance of vigilant monitoring of inflammatory markers during clozapine initiation and supports the use of personalized titration regimens, particularly in East Asian populations who may be at heightened risk of clozapine-induced inflammation."

Journal • Bipolar Disorder • Cardiovascular • CNS Disorders • Gastrointestinal Disorder • Infectious Disease • Inflammation • Mood Disorders • Musculoskeletal Pain • Pain • Pneumonia • Psychiatry • Respiratory Diseases • Schizophrenia • CRP

A pH-mediated stacking CE-MS method for the sensitive determination of clozapine and amisulpride drugs in high ionic strength biomatrices. (PubMed, J Chromatogr A) - "Analysis of patient plasma samples yielded relative differences of 0.9% (clozapine) and 2.8% (amisulpride) compared with UHPLC-MS/MS, confirming good agreement between the two methods. These results indicate that pH-mediated stacking CE-MS provides a practical alternative to UHPLC-MS/MS for therapeutic drug monitoring, with comparable sensitivity, minimal sample consumption, and requiring only liquid-liquid extraction without additional offline enrichment."

Journal • CNS Disorders

Predicting clozapine initiation among patients with schizophrenia via machine learning trained on electronic health record data. (PubMed, Schizophr Res) - "A dynamic prediction model based solely on EHR data predicts clozapine initiation with high discrimination. If implemented as a clinical decision support tool, this model may guide clinicians towards more timely initiation of clozapine treatment."

Journal • CNS Disorders • Psychiatry • Schizophrenia

Clozapine monitoring reform: an access issue, not only a safety question. (PubMed, Br J Psychiatry) - No abstract available

Journal • Agranulocytosis • CNS Disorders • Granulocytopenia • Psychiatry • Schizophrenia

Treatment of Parkinson's Disease-Related Psychosis. (PubMed, Clin Pharmacol) - "When antipsychotic therapy is required, pimavanserin and clozapine demonstrate the strongest evidence for efficacy...Quetiapine is widely used despite inconsistent evidence from randomized trials, largely due to its favorable safety profile and ease of use...Current therapeutic strategies allow symptom control in many patients, yet important gaps in the evidence base persist, particularly regarding long-term outcomes. Future research should prioritize mechanistically informed therapies, standardized outcome measures, and the identification of predictors of treatment response."

Journal • Review • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Movement Disorders • Parkinson's Disease • Psychiatry

Adverse effect MonoPoly: Antipsychotic monopharmacy vs antipsychotic polypharmacy in the treatment of schizophrenia. (PubMed, Indian J Psychiatry) - "This study compared the adverse effects experienced by patients with schizophrenia (excluding those receiving clozapine) treated with antipsychotic monopharmacy (APM) or APP using both subjective and objective assessments...Compared with the APM group, patients receiving APP had a significantly longer duration of illness (P = 0.004; d = 0.55), lower treatment adherence (P = 0.02; d = 0.25), a higher total chlorpromazine-equivalent dose (P < 0.001; d = 1.21), and a higher rate of trihexyphenidyl use (P = 0.01; φ = 0.23). Overall adverse effects were comparable between the APM and APP groups. However, APP was associated with higher antipsychotic and trihexyphenidyl use; more insomnia, restlessness, constipation, and difficulty concentrating; and poorer treatment adherence."

Adverse events • Journal • CNS Disorders • Constipation • Gastroenterology • Gastrointestinal Disorder • Insomnia • Pain • Psychiatry • Schizophrenia • Sleep Disorder

Clozapine-Induced Gastrointestinal Hypoperfusion Leading to Bowel Ischemia and Secondary Atrial Fibrillation: A Case Report. (PubMed, Case Rep Psychiatry) - "His psychiatric management was shifted to haloperidol and olanzapine, and he returned close to his psychiatric baseline over time. This case emphasizes the importance of monitoring for rare gastrointestinal complications associated with clozapine, including hypoperfusion-mediated bowel ischemia, and supports early recognition and prompt discontinuation to reduce morbidity and mortality."

Journal • Atrial Fibrillation • Cardiovascular • CNS Disorders • Pain • Psychiatry • Schizophrenia

Update on Parkinson's Disease Psychosis: Epidemiology, Mechanisms and Management. (PubMed, Neurol Ther) - "Pimavanserin and clozapine are the only pharmacologic therapies for PDP that have been found to be efficacious in randomized controlled trials, though quetiapine is most frequently used despite lacking positive trial results. Future research that continues to clarify the exact pathophysiology of psychosis in PD will improve the current therapeutic approaches, and ongoing randomized clinical trials of these therapies are necessary to identify the safest and most efficacious treatments for PD patients with psychosis."

Clinical • Journal • Review • CNS Disorders • Movement Disorders • Parkinson's Disease • Psychiatry