Hi everyone I hope you’re doing well
My brother is 20, he has resistant schizophrenia, he ended up taking clozapine 200 /day
“ within a month “ the doctor increased the dose to 300/day since 200 didn’t work with him
My question is how long does it take to benefit from clozapine, and do your doctors give you only one month to see the effect or longer? should they increase the dose only in one or give more time ?
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@Rawan it’s actually fairly easy to get info on just about any drug off the Internet. Most of the information isn’t particularly hard to decipher if you take some time to read up on it. Don’t assume you won’t be able to understand it, just push on through.
Here’s the dosing info off of drugs.com
Clozapine dosing information
Usual Adult Dose for Schizophrenia:
Initial dose: 12.5 mg orally once or twice a day
Titration and Maintenance dose: May increase total daily dose in increments of 25 mg to 50 mg per day to a target dose of 300 mg to 450 mg per day (administered in divided doses) by the end of week 2. Subsequent dose increases can be in increments of up to 100 mg once or twice weekly.
Maximum dose: 900 mg per day
Titration means gradually increasing the dosage. As you see the target dose is 300 to 450 mg, so the dosage was on the lower side to begin with. Notice the maximum is 900 mg. Ranges doctor try depend a bit on the weight of the patient, their assessment instinct of how severe the symptoms are etc.
There usually will be some info about ‘therapeutic’ levels and contraindications (reasons why you might want to discontinue the drug). This information is best interpreted by doctors with significant experience, but reading up on drugs as a layman can help you understand why doctors prescribe in certain ways, what sort of side-effects are more likely etc.
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Hello, my son has been on clozapine successfully since about 2007. It takes TIME to see the full efficacy of this drug. It is not uncommon for the doctor to gradually increase it to what they consider a therapeutic level which is usually at least 250 to 300 per day although it can go as high as 600 I have heard from other parents.
My son started out at 100 then went to 200. then 300 (all in the first 6 months or less), and then he stabilized at 300 after about a year, there were no more voices and no more major delusions or visions.
After several years of stability the doctor felt it safe to go back to 250 as the lowest effective dose and when there were no changes in his wellness we have stayed at 250 for at least the past 5 years now and he is still doing very well.
Small improvements can be seen in the first 6 months, but the most improvement is after about a year and then quite honestly I saw more small improvements in many ways continue through out the years. It’s an amazing drug if well tolerated and thankfully my son tolerates it well. Definitely give this drug more time. It is so well worth it in the end.
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Hi! My son , 30 started Clozapine in February this year. He started at 50 mg. He is now at 150 mg but going to 200 mg the end of this week. He is still tapering off Haldol as well. Haldol started causing tardive dyskinesia. So my son’s doctor has been increasing it by 50 mg every few weeks doing it fairly slowly. This week his doctor has requested an additional blood test to see what levels the clozepine is in his bloodstream to see if he is at a therapeutic level yet.
I understand cause of pain takes a long time to see all the effectiveness. Currently it makes my son extremely tired and he sleeps a ton! Hoping he will adjust to it eventually. He hates being what he calls sedated.
I am happy that you have taken an interesting and caring attitude toward your brother. My 3 other sons try to avoid my son’s schizophrenia condition the majority of the time and are not supportive. Mostly in denial I think and fear that their own children may develop it in the future. Take care of yourself and ask doctor many questions.
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Thanks for sharing your experience 
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Thanks for your kind words
Yeah my brother sleeps about 12 hours 
Hope your son and my brother get better soon
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Thanks for your time
The sleeping like that is not unusual. My son still sleeps between 10-12 hours depending on what he did the day before. His doctor use to say that say that sleeping is a healing time even for schizophrenics.
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Dr. Robert .S Laitman
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Well fortunately my grandson was hospitalized and they could bring his clozapine up much quicker. I believe it was 50 MG a day so we could see he was better within 7 days. He came home on 450 MG and lithium. He stayed on this for about a year. They need to check his blood levels and see if it is therapeutic . My grandson only takes 250 MG of clozapine now and he works full-time and has good life. Good luck. Some people I have heard need 900mg
Clozapine doesn’t work for everyone, unfortunately, and is a last ditch medication a lot of time due to side effects. There is a progression of dosage and blood work necessary for each step of the way. My son began laughing like a hyena and at the most inappropriate times. Although he’s been off the Clozapine for more than a year, the laughter still continues. I called the REMS hotline number in the last link below and made sure that my son’s doctor was registered. There have been cases of people showing up at particular pharmacies only to find out that they couldn’t get their prescription filled because their doctor wasn’t registered with the program.
Clozapine has a special hotline set up due to the nature of the drug. The patient has to be registered with the program as well as the pharmacy and the doctor. Also, there’s always the ongoing bloodwork. I spoke to the pharmacy about ongoing issues or side effects.
Here is a link from the National Institute of Health re: Clozapine: Evaluating the Effect of the Changes in FDA Guidelines for Clozapine Monitoring - PubMed
Here is a guide for caregivers: Clozapine REMS
Click on the Important Program Update for additional information: Clozapine REMS
`hope these help! 
thanks that’s very helpful
Thanks for sharing hope he gets well soon
That’s very nice thank you so much 