Does Reducing Clozapine Dose Cause Diarrhea, Nausea, Headache And Fatigue?

Posted on Tue, 26 May 2015

Question: I have been stable on a low dose of clozapine for years. Couple of weeks ago I reduced the dose slightly (only by 12.25mg- half a 25mg tablet). Mid last week I developed bad diarrhoea, nausea and headache and been tired and weak. Tonight I had a 'panic' like moment that lasted maybe half an hour. It felt like I was on drugs or something. I don't take any drugs or drink. I am really worried it will happen again. Do you think might be withdrawal symptom? Stress of being sick? Main question- should I continue tonight on reduced dose or go back up to the dose I was on? Thanks

Answered by Dr. Seikhoo Bishnoi (53 minutes later)

Brief Answer:
In my opinion these symptoms are not due to Clozapine withdrawal

Detailed Answer:
Hello thanks for asking from HCM for your health related queries

I can understand your concern. Clozapine is a second generation anti-psychotic drug. The drug is commonly used in doses of 50-200 mg and in some patients even higher doses are used. You have reduced the dose by 12.25 mg and I don't think that reduction of dose has caused the symptoms like diarrhoea, nausea, headache, tiredness or panic like symptoms. This is probably not due to withdrawal of Clozapine. Some times when a patient has take some psychoactive drug for long and doses are reduced due to a lot of psychological process, some mild withdrawal symptoms can be observed. You have reduced the doses a couple of weeks ago so in my opinion no need to worry.

So

- I don't think these symptoms are due to withdrawal from Clozapine.

- Such symptoms could be occurring due to some anxiety due to some stress or some unconscious psychological stress. In my opinion low dose benzodiazepines like Clonazepam, Lorazepam etc can help. These medicines will reduce the symptoms and you will feel better. Discuss with your doctor for prescription and evaluation.

- In my opinion you should continue with reduced doses and should not go back to normal doses because already two weeks have passed since you reduced the dose.

Please visit your doctor if symptoms persist or worsen.

Thanks, I hope this helps you. Please feel free to ask again if you have more doubts.

Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (19 minutes later)

Unfortunately was time to take dose and had to make a desision if to take dose I've been taking for two weeks or the previous dose. I choose to go between and instead of taking off 12.35mg I took off 6.18mg. Will this be ok?

Answered by Dr. Seikhoo Bishnoi (45 minutes later)

Brief Answer:
No need to worry for that

Detailed Answer:
Hello again and thanks for a follow uo

Yes that would not make much difference. No need to worry. The symptoms are not due to withdrawal.

Thanks, still have more doubts please ask again

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar