Clozapine, sold under the brand name Clozaril among others, is an atypical antipsychotic medication. It is mainly used for schizophrenia that does not improve following the use of other antipsychotic medications. In those with schizophrenia and schizoaffective disorder it may decrease the rate of suicidal behavior. It is possibly more effective than typical antipsychotics and in those who are treatment resistant. It is taken by mouth.
Clozapine is associated with a relatively high risk of low white blood cells which may result in death. To decrease this risk it is recommended that the blood be regularly monitored. Other serious risks include seizures, inflammation of the heart, high blood sugar levels, and in older people with psychosis as a result of dementia an increased risk of death. Common side effects include drowsiness, dry mouth, low blood pressure, trouble seeing, and dizziness. The potentially permanent movement disorder tardive dyskinesia occurs in about 5% of people. Its mechanism of action is not entirely clear.
Clozapine was first made in 1958 and sold commercially in 1972. It was the first atypical antipsychotic. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. It is available as a generic medication. The wholesale cost in the developing world is between 0.05 and 2.10 USD per day as of 2014.