Family and Caregiver Schizophrenia Discussion Forum

Different manufacturers of clozapine - any differences?

My son has been doing fairly well on clozapine for about a year now. He is 20 and takes 350 mg a day. The voices are fairly well controlled although it seems like every other day or every two days the voices are more prevalent and troublesome. He has been on three different manufacturers of clozapine. One was an oval shaped pill, one a small round pill with a divider line, and most recently today a slightly larger pill with a divider line.

Has anyone noticed that one manufacturer is better than another in terms of controlling the voices?

It just seems like lately my son has had a few more symptoms and nothing has changed other than the manufacturer.

Just curious?

I don’t have experience w that specific drug, but what you can do is insist on the brand name, not the generic to ensure consistency.

I have not noticed any differences myself --my son has been on it for close to 10 years with different manufacturers and always generic, my son hasn’t had any reoccurring voices for at least 8 years …maybe talk to the doctor and see if his dosage is optimal. My son started off on a higher dosage but over the years has been able to reduce it some with no changes in behaviors. One more thought, I don’t know if your son smokes or drinks caffeinated drinks but if so …differences in nicotine or caffeine intake on any given day can change the effectiveness of clozapine for that day. My son finally settled on 1 large mug of coffee each morning and about 1/2 pack of cigarettes each day and 1 Pepsi in the evening. It took a long time to get to that stability with those items but now it works. Also one more thing that I can pass on from my son’s experiences (and everybody is different) but my son became the most stable after his first year on the drug, I did see many improvements the first year , but even more the 2nd. Truthfully even after 10 years I still see slight improvements in his personality, his humor and inquisitiveness, things that were lacking early on.

I haven’t noticed differences either. For us, changes around this time of year are usually due to holiday anxiety. I just make sure he knows it is the same medication, just a different manufacturer so he doesn’t get suspicious and become tempted to not take it.

My insurance will pay for some manufacturers, but not others. Sometimes the pharmacy doesn’t understand that and we have to go through a denial until I tell them to select the second one on the list!

Definitely check the consistency of caffeine and/or nicotine use. As @Catherine mentioned, I have read that these things make a difference. It also could be that the Clozapine dose needs to be changed but you are understandably desiring to avoid that if there is another solution. The book about by Dr. Laitman “Meaningful Recovery from Schizophrenia and Serious Mental Illness with Clozapine” contains a chapter about adjunct medications and when and why they might be needed. We have not needed to try any of these adjunct meds but I felt it to be a worthy resource.


I’ll have to look into that book, that’s one I have not seen yet. Throughout the years my son has had other medications, for the first 5 years he took Zoloft, now he takes Depakote and Cogentin with the clozapine.

Thanks for the question, AmyinColorado. I didn’t even consider that my son’s clinic could be dispensing different manufacturers of clozapine. My son has been on it for 1 year and it’s an absolute miracle in our life. It hasn’t removed all the voices and delusions but it’s so much better. Sorry I can’t comment on the different manufacturers but I can comment on Dr. Laitman’s book which I found very helpful. He’s currently also prescribed Invega shot every month and I’m wondering if that is really necessary with the clozapine. Take care.

Glad you re-opened the thread. I would never ever just feed somebody or take any pill that was suddenly unfamiliar. In shape color or print. My advice, discuss it thoroughly with your pharmacist or look it up online (every time you actually visually see something different than what they were taking). There are many fact-check sites online with all commercial names for medications, generic names, stamps (what you see on both sides of the pill), size, shape, and color. If something is different, I’d suggest looking it up, in multiple resources. Note: often times the same medication may look very different dispensed in different dosed but still be a single pill.
Always do your own homework.

I cannot tell you to go against the doctor’s orders, but I think if you are able to do so, it is worth discussing if the multiple medications are necessary.

The pharmacy we use tends to use one of 2 different manufacturers. The pills look distinctly different, but I have been able to explain to my son it is the same medication, just made by different companies. I haven’t seen any difference in their effectiveness.

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