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We reviewed the incidence,clinical features,and management of all clozapine-related seizures in 5,629 patients monitored by the Clozaril Patient Management System,during the first 6 months after marketing. Seventy-one patients had generalized tonic-clonic seizures yielding a frequency of 1.3%.One patient had myoclonic seizures prior to generalization.Seizures tended to occur at low doses(<300 mg/d)during the titration phase,and at high doses(>/=600 mg/d)during the maintenance phase.Patients with a history of seizures or epilepsy were more likely to have seizures soon after initiation of therapy,on low doses.Twenty-nine of 37 patients(78%)who had seizures and were rechallenged with clozapine were able to continue the medication with dose reduction and more-gradual dose titration,or with the addition of an antiepileptic medication. |
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