PsychRounds: The Psychiatry Podcast

Clozapine (Clozaril) with Dr. John Kane

10 snips
Feb 5, 2025
Dr. John Kane, a distinguished psychiatrist with decades of experience, dives deep into clozapine, a revolutionary medication for treatment-resistant schizophrenia. He shares its tumultuous history, including safety concerns that challenged its FDA approval. Dr. Kane highlights the drug's underutilization and intricate monitoring requirements that complicate patient access. The discussion extends to new advancements in schizophrenia treatments, underscoring the urgent need for comprehensive education for patients and families in navigating these complex issues.
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ANECDOTE

Dr. Kane's Clozapine Discovery Story

  • Dr. John Kane took over patients from another investigator to continue clozapine treatment despite initial plans to discontinue it.
  • He found clozapine highly effective for treatment-resistant schizophrenia, leading to pivotal FDA-approved studies.
ADVICE

Preventing Clozapine Constipation

  • Screen for gastric hypomotility and discontinue other contributing meds before starting clozapine.
  • Use stool softeners, osmotic agents, and stimulants together to prevent fatal constipation.
ADVICE

Treating Clozapine Sialorrhea

  • Address clozapine-induced sialorrhea seriously because it's common and can cause aspiration pneumonia.
  • Use atropine drops and botulinum toxin B injections for effective treatment.
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