For those who aren’t familiar with Clozapine, it’s an antipsychotic medication often prescribed when other treatments for schizophrenia have failed. But here’s something you might not know—clozapine infection risk in schizophrenia is real, and it’s especially concerning in older adults.
Clozapine works by changing the actions of chemicals in the brain, offering relief to many who struggle with schizophrenia. However, a recent study linked this medication to a 25% higher risk of infection compared to other antipsychotics. Even more alarming? For people over 55, the risk of infection jumped by 45%. Those are numbers worth paying attention to in senior living communities, where chronic health conditions are common.
When you look at who’s most vulnerable, it’s easy to see how Clozapine might create added challenges. According to prescribing guidelines, the medication may cause adverse reactions in people with heart conditions, high blood pressure, a history of stroke or heart attack, electrolyte imbalance, liver or kidney disease, high cholesterol, constipation, and more. How many of your residents fall into one or more of those categories?
Researchers behind the infection study expressed concern over recent suggestions to loosen requirements for regular bloodwork monitoring in residents taking Clozapine. While these testing guidelines can feel burdensome, the findings make it clear that follow-up care is essential for early detection and proper management of infection risk. For reference, the infection risk findings were published in this peer-reviewed article on the increased infection rates among Clozapine users with schizophrenia, which you can read in full via Psychiatric News from the American Psychiatric Association at Clozapine May Up Infection Risk in Schizophrenia.
What’s more, even though Clozapine is not listed on the BEERS Criteria for potentially inappropriate medications in older adults, it remains a powerful antipsychotic. Interestingly, it’s noted as an exception in cases where older adults with Parkinson’s disease may need treatment, but that doesn’t mean it’s without concern. Especially when you consider how quickly a mild infection can escalate in older people.
So what does this mean for your residents? It might be time to have a conversation with the attending physician about whether an alternative exists. Clozapine can be a life-changing medication for some, but its risks deserve just as much weight as its benefits.
As always, use your clinical resources like the BEERS Criteria as a guide, but not a final answer. Stay current on the research. Stay attentive to the manufacturer’s recommendations. And above all, watch for early signs of infection. When we’re caring for residents on Clozapine, diligence matters more than ever. Understanding and monitoring clozapine infection risk in schizophrenia helps ensure your residents receive the careful attention they deserve.
Stay well and stay informed!
