Abstract
Clozapine is a second-generation antipsychotic mostly used for treatment-resistant schizophrenia and acute suicidality. Although clozapine’s efficacy is well-documented, it has various side effects which need to be promptly addressed. In this article, we focus on neurological and psychiatric side effects. Among these side effects, seizure is a well-known complication of clozapine therapy. The articles that we reviewed concerning seizures and EEG changes in association with clozapine plasma levels and doses, found significant relations in some but not all cases. In addition to seizures, extrapyramidal side effects are common adverse effects of clozapine which can be an acute or chronic condition. Clozapine is also associated with ocular disturbances such as retinal pigmentation. It has also been shown to cause cataplexy. Moreover, clozapine can cause significant sedation. Effects of clozapine on sleep is still a controversial subject. The studies demonstrate inconsistent results. Cholinergic rebound syndrome is a rare complication of longterm clozapine use, which itself can be the inducer of insomnia. Apart from this, hypersalivation is one of the most frequent side effects with a paradoxical pathophysiology. Finally, clozapine is associated with severe psychiatric side effects, some of which need prompt intervention.
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