Clozapine
MedicationWikipedia
93
MENTIONS
9
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Search complete. 93 mentions across 9 episodes found for "Clozapine".
Sep 17, 2026
Cody ArmstrongHOST
So knowing how they interact with the different receptors is going to help you understand the different side effect profiles.
Cody ArmstrongHOST
Now, most of these medications, as far as like positive effect is concerned, are relatively equal, okay? It's kind of like Clozapine's the best, but we don't use it first or second.
Cody ArmstrongHOST
Olanzapine is next best, but we don't use it first.
Cody ArmstrongHOST
And then everything else is just kind of equally effective.
Ken BerryHOST
and mental health issues can absolutely cause secondary hypertension.
Ken BerryHOST
Tegretol, Clozaril, Lithium, any of the monoamine oxidase inhibitors used for mental health problems can cause secondary hypertension.
Ken BerryHOST
Any of the like Prozac, Paxil, Zoloft, Lexapro, Effexor, and some people can cause secondary hypertension.
Ken BerryHOST
Any of the serotonin norepinephrine reuptake inhibitors, again used for mental health issues, can cause secondary hypertension.
Justin RayGUEST
And, and McDonald's.
Justin RayGUEST
And the difference in how she is now, and, you know, she's on Clozaril, right? The miracle drug.
Michael MachniakHOST
Yeah, yeah.
Justin RayGUEST
And, and I've had to fight her a lot on staying on this drug, right? Because she gets the sialorrhea and the hypersalivation.
Justin RayGUEST
I mean, the things that are currently in the pipeline now, like we're going in a completely different direction antipsychotic wise, where we're talking about the muscarinic r- revolution and Cobenfy and, you know, others.
Justin RayGUEST
There's-- I think there's 10 muscarinics currently in the pipeline under active trials, and so it's a completely different way of approaching the disease process.
Justin RayGUEST
I've seen like, like cognition just shift, and now we've come to find out that cloz- we believe that Clozaril is also a muscarinic drug because we could never figure out, like, why is this the magic medication, because it doesn't really have a lot of D2 affinity.
Justin RayGUEST
So what can it be? But now when we think about the hypersalivation, right, that makes sense that it's hitting M1 probably in the brain, and that's a byproduct.
Lane PeytonGUEST
And so he committed to medication.
Lane PeytonGUEST
We got him on Clozaril.
Lane PeytonGUEST
Which is really, really old, but still better than the more recent meds up until our Coventry.
Lane PeytonGUEST
Like we really have, I mean, for years we've been happy if people are sedentary and fat and dull and sitting on the couch as long as they're not talking out of their ear holes.
Lane PeytonGUEST
But what about that quality of life? What about your productivity volunteer? His parents always wanted to know if maybe he could work.
Lane PeytonGUEST
He's now working a low-grade job.
Lane PeytonGUEST
He's been on Clozaril for a year.
Lane PeytonGUEST
What really got through to him was framing the decision and playing bocce ball with him out in the backyard where there's that old apartment complex and a grassy knoll.
KimHOST
Part two, but she waited and he was on all kinds of antipsychotics, um, kind of maxed out on the, this one.
KimHOST
And she waited till 10 to start him on Clozaril, which is, we've talked about it before.
KimHOST
It's the number one treatment for schizophrenia, but it comes with extreme risks
JeffHOST
and instant death.
JeffHOST
And Despite all the new medications that come out, they, at least for us, you know, they haven't come up with anything that's better.
KimHOST
Not for him anyways, but the fact that she was willing to start that medicine when he was 10.
KimHOST
And she had done a ton of research, and she was working with another psychiatrist that deals with extreme cases like Kaysen, who he uses Clozaril.
KimHOST
And she was like, okay, we're going to start low, and we're going to be very careful, and we're going to do the weekly blood labs, and we're going to do this.
Craig HarperHOST
I cook Craig Anthony Harper and Matthew Gerald William Longfellow Bernstein.
Craig HarperHOST
What's your middle name, Matt? Do you have one?
Matthew BernsteinGUEST
I do.
Matthew BernsteinGUEST
It's Evan.
Matthew BernsteinGUEST
Evan,
Craig HarperHOST
that's not very exciting.
Craig HarperHOST
Let's give him another one.
Craig HarperHOST
Let's give him another one.
speaker_2UNKNOWN
Our job isn't to say, have you considered lithium? Our job is to make sure that the clinician making those decisions has good information about what we're seeing.
speaker_2UNKNOWN
Clozapine is an antipsychotic used in the treatment of schizophrenia, particularly when someone hasn't responded adequately to other antipsychotic medications.
speaker_2UNKNOWN
What's particularly relevant to our discussion is that Clozapine also has a specific FDA indication for reducing the risk of recurrent suicidal behavior in people with schizophrenia or schizoaffective disorder who are considered at chronic risk for suicidal behavior.
speaker_2UNKNOWN
That's an important one to know because it's one of the relatively few psychiatric medications with an FDA indication that specifically addresses suicidal behavior.
speaker_2UNKNOWN
Then we have ketamine and esketamine, which are often talked about together, but they're not exactly the same thing.
Manaan KarrayHOST
That is fascinating.
Manaan KarrayHOST
But then there's Clozapine.
Manaan KarrayHOST
Every time I read about psychopharmacology, Clozapine breaks the rules.
speaker_1GUEST
Clozapine is the ultimate outlier.
speaker_1GUEST
Clozapine, along with Questupine and a much newer drug called Lumataperone, are highly unusual because they appear to achieve clinical efficacy with only about 40% postsynaptic D2 occupancy in the striatum.
Manaan KarrayHOST
How does that even make sense? If the golden rule is 60 to 70%, how is Clozapine clearing a psychotic episode with only 40% of the chairs covered?
speaker_1GUEST
It remains an area of intense neurobiological debate.
speaker_1GUEST
The prevailing theory relies on its fast-off kinetics.
Randye KayeHOST
Mm.
Miriam FeldmanHOST
Um, sh- we're six years into it, and she's on Clozapine, and she's always been 100% treatment compliant.
Miriam FeldmanHOST
This kid has never tried to cheat a med or do anything, right? She has always done what I've asked her to do.
Nicole Drapeau GillenGUEST
do.And yet, you know, years into Clozapine, she's at the highest level in terms of what's acceptable in her body.
Nicole Drapeau GillenGUEST
She still has delusions.
Nicole Drapeau GillenGUEST
She still hears voices.