Monday, October 5, 2015

Sizopin uses and side effects

Sizopin is an Indian brand name of the generic medication clozapine. It is prescribed specifically in resistant schizophrenia. However, this medication has several dangerous side effects such as reduced blood counts (agranulocytosis) and inflammation of heart muscles.

Uses of Sizopin

This is the only medication that has proven efficacy in resistant forms of Schizophrenia. It is usually prescribed when the symptoms of schizophrenia does not respond to two or more anti-psychotic medications. It is used as a third line medication, because of its potentially dangerous side effects and cumbersome monthly blood tests that has to be done in a patient on Sizopin.   

Sizopin 100mg tablets
Because of life threatening agranulocytosis (reduction of type of white cells called granulocytes in blood) it had been withdrawn from the market. But it was reintroduced due to its effectiveness in treating resistant schizophrenia, so frequent white cell counts should be done in patients who take Sizopin. Patients on Sizopin must be registered with a central monitoring agency.

Following video will explain the importance of treating treatment resistant schizophrenia by an expert in the field.

In addition, to the use in resistant schizophrenia some psychiatrists use it in patients with resistant mania, and psychosis associated with Parkinson disease/ Lewy body dementia.

Schizophrenia : Artists depiction

How Sizopin is prescribed?

This medication is prescribed usually when the patient is in a hospital. Before starting medication doctors do various blood tests including, full blood count, liver function test, electro cardiogram and a 2D echocardiogram to exclude any medical problems. It is usually started with a small dose of 12.5mg at night then it is gradually increased up to desired level. While the dose is increasing, doctors monitor patients’ blood pressure, heart rate, and emergence of side effects.

Increased heart rate is common at the initial period of therapy

Due to increased risk of fits with higher doses, doctors give this medication with anti epileptic medication such as Sodium Valproate.

At the initial period, a patient should undergo blood tests every week upto six months then two weekly up to one year and after that monthly for the rest.

It is very important not to discontinue the medication for more than 48 hours as it need to be restarted from 12.5mg after that. If you have problems with the medication then contact your doctor and do as he/she says.

Monthly blood tests should be done when you take Sizopin

Common side effects of Sizopin

Sedation (excessive sleepiness)

Sedation can be alleviated by altering the dosing schedule, so patient can take small dose at the morning and a bigger dose in the evening.


It is a common side effect. This can be controlled by taking high fibre diet (diet with lots of fruits and vegetables) and adequate fluid intake.

Increased heart rate

Increased heart rate is a common side effect at the initial period of therapy. If it is persisting a doctor will look for heart problems.


Patient should seek medical advice. It can be due to agranulocytosis. If not, can be treated with over the counter antipyretics like acetaminophen.

Hypersalivation (Increased saliva secretion.)

This is usually a troublesome side effect. Patients sometimes discover that their pillow is soaked with saliva after getting out from sleep. Doctors can give drugs like buscopan to control salivation.

Hypertension (increased blood pressure)

It is another side effect that has to be monitored. If it is persistent doctors can start anti hypertensives. This usually occur after sometime.

Hypotension (decreased blood pressure)

Hypotension can occur at the initial treatment phase. If they have this problem, they should not get up quickly after sleep, then should be monitored closely by a doctor.


It is a common side effect. Doctors can start anti emetics if it becomes troublesome.

Passing urine during sleep (Nocturnal Enuresis).

It is another troublesome side effect. Patients can avoid fluids in evening. When complained, doctor can alter dosing schedule. Sometimes drugs may be necessary to control enuresis.

Serious side effects

Blood problems

Sizopin is known to cause serious drop in white blood cell counts known as agranulocytosis. It is a very serious medical complication that need urgent attention. You need to contact your doctor immediately if you have developed infections, fever, and sore throat at the initial part of the therapy. It usually occur more at the initial part of the treatment. However, it affects only 0.8% of patients who takes this medication and therefore is not a common side effect.

Seizures (fits)

If patient had a seizure, drug should be withheld for at least 24 hours. Then doctor will restart with lowest possible dose. Sometimes doctors may prescribe anti epileptic drugs.

Heart problems

This medication is known to cause heart disease known as myocarditis or inflammation of the heart muscle. It occurs in early part of the illness and usually diagnosed by a doctor with electrocardiography and 2D echo.

Weight gain is another problematic side effect. It can be controlled by following proper dietary advice. This can also cause diabetes mellitus and blood lipid problems. You should inform your doctor if you have diabetes, hypertension, liver and kidney problems, heart problem or epilepsy before getting prescription of this medication.

Risk and benefit of this medication

Patients with resistant schizophrenia has serious problems in functioning and this medication can change it and around one third of patients with resistant schizophrenia can live normally with this medication. Therefore, in patients with resistant schizophrenia benefit greatly outweighs risk of taking Sizopin.


Sizopin is a medication prescribed for resistant schizophrenia. It can cause serious and annoying side effects, but for patients with resistant schizophrenia there seems to be no better alternative. 

First published in
Mental health information blog

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