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Clozapine may have to be withdrawn rapidly if a blood dyscrasia develops. This study found that nearly two thirds of schizophrenic patients who abruptly discontinued as little as 200 mg/day of clozapine experienced withdrawal symptoms ranging from physical discomfort to acute psychosis.
During an investigation of the pharmacodynamics of clozapine, 28 patients aged 18 to 55 with residual or remitted schizophrenia were switched from their previous antipsychotic regimens to 200 mg/day of clozapine. After clozapine was given for 20 days, it was withdrawn abruptly and the previous regimen was reinstituted 3 days later. Within 1 to 4 days after stopping clozapine, 12 patients experienced mild agitation, headache, and/or nausea lasting as long as a…