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Main indications of clozapine in clinical practice: A literature review

Published online by Cambridge University Press:  26 August 2025

P. Rivero Rodriguez ,
M. Martinez Grimal ,
J. J. Tascón Cervera ,
A. M. Morales Rivero  and
F. A. Rodriguez Batista
P. Rivero Rodriguez*
Affiliation:
Psychiatry, Hospital Universitario de Gran Canaria Doctor Negrin, Las Palmas de Gran Canaria, Spain
M. Martinez Grimal
Affiliation:
Psychiatry, Hospital Universitario de Gran Canaria Doctor Negrin, Las Palmas de Gran Canaria, Spain
J. J. Tascón Cervera
Affiliation:
Psychiatry, Hospital Universitario de Gran Canaria Doctor Negrin, Las Palmas de Gran Canaria, Spain
A. M. Morales Rivero
Affiliation:
Psychiatry, Hospital Universitario de Gran Canaria Doctor Negrin, Las Palmas de Gran Canaria, Spain
F. A. Rodriguez Batista
Affiliation:
Psychiatry, Hospital Universitario de Gran Canaria Doctor Negrin, Las Palmas de Gran Canaria, Spain
*
*Corresponding author.

Abstract

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Introduction

Clozapine is an atypical and complex antipsychotic that appears to benefit from actions on multiple neurotransmitter systems. While its mechanisms of action are not fully understood, this broad spectrum of activity accounts for clozapine’s superior efficacy in treating refractory schizophrenia and other conditions.

Objectives

The aim of this paper is to review the main indications of clozapine and its applications in clinical practice, as well as to highlight key considerations for its safe and effective management.

Methods

A systematic review of the scientific and clinical literature on clozapine was conducted. The review included databases such as PubMed and Cochrane, covering articles from the past 20 years. The scientific evidence obtained was analyzed and synthesized.

Results

Findings indicate that clozapine remains the treatment of choice for patients with treatment-resistant schizophrenia, showing a superior response rate compared to other antipsychotics. Additionally, its effectiveness in reducing suicidal behaviors in patients with schizophrenia and related disorders has been identified. The indications also extend to psychosis in Parkinson’s disease, substance use disorders, and a wide range of psychiatric and neurological disorders.

Conclusions

Clozapine is essential in the treatment of refractory schizophrenia and in reducing suicide risk. Its broad mechanism of action, affecting multiple neurotransmitters, allows its use in secondary psychotic disorders and complex comorbidities, such as Parkinson’s disease. However, its use is associated with significant risks, necessitating rigorous monitoring of adverse effects.

Disclosure of Interest

None Declared

Information

Type
Abstract
Information
European Psychiatry , Volume 68 , Special Issue S1: Abstracts of the 33rd European Congress of Psychiatry , April 2025 , pp. S1115 - S1116
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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