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Dear Rachel,. Sorry about your dad. There is clearly a downside to Clozaril. There are numerous side effects which may be making your dad feel physically worse and possibly even add to the confusion. It does nothing for dementia- that is the aspect of his problem where he is losing his memory as the result of loss of brain cells. The sedation (although it likely will pass) may make it even harder for him to attend to the world around him and remember and understand what is happening to him. Also there is a 3% risk of aplastic anemia which if not caught early can be fatal. It is MANDATORY in order to even get the drug from a pharmacy that weekly blood tests be carried out. There can also be other physical symptoms with the drug. So why prescribe such a risky drug? Every other antipsychotic medication blocks the effect of dopamine receptors in the basal ganglia as well as the rest of the brain. Clozaril has a unique effect providing much less blocking of these receptor sites. The L-DOPA that we take for PD turns into Dopamine increasing this neurotransmitter everywhere. It does not discriminate which receptor sites are being stimulated too much and which are not getting enough dopamine. The receptors (the place where the dopamine acts) are different in different parts of the brain. When the dopamine stimulation gets too strong in certain parts of the brain- hallucinations and delusions can occur. And in other parts of the brain other problems like hypersexuality may occur. If your father's hallucinations are being caused by his PD meds- which act by stimulating the dopamine receptors - usually nonselectively, then there is reason to hope that he will improve if he is able to get past the side effects. But, if the cause is his general brain derioration, then it is much less likely to help. It certainly was worth a try. I know Rush-Presbyterian has a large series of patients who they have given Clozaril to and likely any of the neurologists in that group would be able to make informed decisions regarding your dads treatment. I know it's frustrating talking to an on call MD but the option is having doctors who do nothing but medicine and then wind up either burning out or becoming so isolated from non-medical people that they lose the ability to empathize. I hope things go better. It is worth a try- but frustrating when things don't go well. Hang in there. Charlie >My father, who is 76 yrs old and has had PD for over 20 yrs, was displaying >psychotic behavior. I heard about Clozaril on this list and several >people said they had good results with it. So we asked my Dad's doctor >(Dr. Goetz, in Chicago) and they decided to put him in the hospital to begin >treatment. My dad went on the drug last Friday and it has been terribly >down hill ever since. He is more agitated, very sleepy, extremely >disoriented, and mumbles alot. His sleeping pattern is all turned around >so he sleeps during the day and is awake at night. Since it was a >holiday weekend, we could not get a doctor to look at him until Tuesday. >We never did get ahold of Dr. Goetz (he wouldn't return phone calls). A >Neurologist who did see my Dad, decided to lessen the dosage of Clozaril >and to take my Dad off Parlodel. All I know is my Dad is exhibiting >behavior he never has before he went on this drug. The doctors did an >MRI which showed my Dad's brain had atrophied, but they said it was not >related to PD. Has anyone else has such bad luck with Clozaril? The >doctors are saying it affects everyone differently. > >- Rachel Balsam ([log in to unmask]) > > **************************************************************************** ************************************* Charles T. Meyer Madison, WI [log in to unmask] **************************************************************************** ************************************