Clozapine: Atypical Origins & Clinical Pearls - PsyQ Episode 4

This two-part episode takes a comprehensive look at clozapine, one of psychiatry's most impactful and complex medications. The two parts are (1) context, and (2) clinical pearls. We explore its challenging history, landmark clinical trials, unique pharmacology, practical prescribing guidelines, and the recent evolution of its regulatory oversight. Essential listening for psychiatry trainees and practicing clinicians.Sources used:1. Kane (1988). Clozapine for the Treatment-Resistant Schizophrenic: A Double-blind Comparison With Chlorpromazine. Arch Gen Psychiatry2. Hippius (1999). A Historical Perspective of Clozapine. J Clin Psychiatry3. Clozapine—serious adverse effects and clinical management. Chapter 12 in Antidotes to Toxins and Drugs.4. FDA. Feb 2025 Information on Clozapine. FDA.gov.5. Schneider-Thoma (2025). Efficacy of clozapine versus second-generation antipsychotics in people with treatment-resistant schizophrenia: a systematic review and individual patient data meta-analysis. Lancet Psychiatry This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit upathak.substack.com