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Patients should be advised to report immediately which of the following signs or symptoms when on Clozapine therapy? [Select ALL THAT APPLY].

a. Lethargy
b. Fever
c. Sore throat
d. Weakness
e. Severe nausea and vomiting

Answer: (a,b,c,d). Clozaril (Clozapine), an atypical antipsychotic drug, is indicated for:

1. Treatment-Resistant Schizophrenia
2. Reduction in the Risk of Recurrent Suicidal Behavior in Schizophrenia or Schizoaffective Disorders

Because of a significant risk of agranulocytosis, a potentially Life-threatening adverse event, Clozaril (Clozapine) should be Reserved for use in

(1). the treatment of severely ill patients with Schizophrenia who fail to show an acceptable response to Adequate courses of standard antipsychotic drug treatment,

Or

(2). for reducing the risk of recurrent suicidal behavior in patients With schizophrenia or schizoaffective disorder who are judged to Be at risk of reexperiencing suicidal behavior.
Patients being treated with Clozapine must have a baseline white Blood cell (WBC) count and absolute neutrophil count (ANC) before initiation of treatment as well as regular WBC counts and ANCs during treatment and for at least 4 weeks after Discontinuation of treatment.

Clozapine is available only through a distribution system that Ensures monitoring of WBC count and ANC according to the Schedule described below prior to delivery of the next supply of Medication.

Agranulocytosis, defined as an ANC of less than 500/mm3, has been reported with Clozaril (Clozapine). Patients should be advised to report immediately the appearance of lethargy, weakness, fever, sore throat or any other signs of infection occurring at any time during Clozaril (Clozapine) therapy. Such patients should have a WBC count and ANC performed promptly.