Do the Benefits of Clozapine Outweigh the Risks?

drug therapy for autismClozapine is approved by the United States Food and Drug Administration (FDA) solely for the use of treatment-resistant schizophrenia. Clozapine was the first atypical antipsychotic drug to be developed. Also known by brand names such as Clozaril, Denzapine, FazaClo, Leponex, and Zaponex, this drug is generally only used as a last resort in patients that have had no result with other anti-psychotic treatments. Clozapine has the possibility of causing a dangerous decrease in the number of white blood cells in an individual, which can be life-threatening. Its use requires the individual taking the medication to undergo regular white blood cell and absolute neutrophil counts. This medication carries five black box warnings for agranulocytosis, epileptic seizures, myocarditis, increased mortality in elderly patients who have dementia-related psychosis, and other adverse cardiovascular and respiratory effects.

This antipsychotic medication is prescribed off-label for children with autism spectrum disorder, as it helps reduce hyperactivity, fidgeting, and aggression. This medication is not available for children under 16-years-old, as its safety and effectiveness has not been established for those under this age. However, the risks that come with this medication are a concern when it comes to children, adults, older patients, or people who already have the risk of experiencing seizures. Serious possible side effects include bowel infarction, and clozapine has been associated with myocarditis and diabetes.  Other less serious side effects that may occur are hyper-salivation and weight gain. Common side effects, most of which are minor, include constipation, bed-wetting, drooling, muscle stiffness, sedation, tremors, orthostatic hypotension, and hyperglycemia.

Regardless of the negative side effects, many researchers find that clozapine has the ability to help those with autism. Clozapine is believed to block neutransmission due to the dopamine and serotonin dispersed by neurotransmitters in the brain’s limbic system, which is associated with an individual’s emotions and motivation. Doctors, however, are hesitant to prescribe clozapine to children or adolescents, because of the risk of arganulocytosis, which can be deadly. A physician should be called in case the individual taking clozapine shows signs of a very bad reaction, any signs of infection, fever, chills, sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, painful urination, dizziness, trouble breathing, increased heart rate, change in balance, bad headaches, feeling tired or weak, weight loss, weight gain, frequent urination, swelling in the legs or stomach, rashes, or the child’s health problem does not get better or gets worse.

This medication can only be obtained by drug order, so it is imperative that the possibility of a child being put on clozapine to help alleviate the symptoms of autism be discussed with his or her physician. Like many medications, clozapine may interact with other drugs, causing negative effects. Before starting clozapine, a complete list of the drugs an individual is taking should be discussed with a doctor. The side effects listed in this article are not all of the side effects that may occur while taking clozapine. Questions regarding the side effects of this medication and further advice should be acquired from a qualified physician.