However, there is no consensus of the types of antipsychotics [eg, one novel and one conventional versus two novels versus two conventionals] or the dosing and duration of each trial). In this population, both positive and negative symptoms have been shown to improve more significantly with clozapine than with conventional antipsychotics. However, the advantage for negative symptoms has not always been observed and has come under scrutiny more recently. Other important effects of clozapine use are its apparent reduction in risk for suicide and beneficial effects on persistent aggression in schizophrenia. buy ampicillin
Clozapine is also associated with little or no risk for EPS and TD and has been suggested for the treatment for neuroleptic-induced EPS. However, the widespread use of clozapine is limited by its significant risk for agranulocytosis (approximately 1%). Through stringent hematological monitoring by the Clozaril Support and Assistance Network (CSAN), the actual incidence of agranulocytosis has been reduced substantially. Common nuisance and serious side effects include sedation, orthostatic hypotension, sialorrhea, gastrointestinal complaints (constipation, esophageal reflux), weight gain and seizures, which also reduce the overall acceptability of clozapine. Many of these resolve over time, with weight gain being a notable exception. Aggressive monitoring and treatment of these adverse effects are recommended to improve compliance.