Is there any options left after clozapine fails

Are there any options left, is there any med that is effective after clozapine fails

There are many, many options even after Clozapine fails.

There is a full list below, plus many people here are seeing success adding some supplements like Sarcosine and NAC, etc. which seem to target the same brain receptor as Clozapine - so another medication with the amino acids / supplements might be even more effective than Clozapine, without the Clozapine issues. See list of links below.



N-Acetyl cysteine (NAC)



In what sense has clozapine failed in this case?

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Wow this is an awesome thread! Thanks for the info. I tried clozapine - but after a few days had to stop - white blood cell count fell very quickly.

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Clozapine never worked for me. It destroyed my sense of balance so badly I couldn’t function.

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it didnt work for me also… i was more paranoid than in my schizophrenia, ive stopped eating and had more panic attacks on it… i was also akathisic on it. i came back on zyprexa…i didnt find that clozapine is a miracle drug,its a way too strong also :/…

Couldn’t tell if it was clozapine doing that or seroquel. I felt dizzy, I felt weak, I felt like I was going to die or pass out, and felt physically sick. I also have a sore throat, constipation, and mouth sores.

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I know this is an old post, but I would like to share with Karl our experiences with Clozaril. My son tried different anti-psychotics without success. We were told that clozaril is the “gold standard” for psychosis, and it was finally prescribed during a hospitalization. We felt crushed and hopeless when his white blood count and neutrophils dropped into the danger zone after only a week.
A year later, after being on Zyprexa and Prozac and 8 ECT treatments, he was hospitalized again. I convinced the doctor to try lithium. We knew someone with severe treatment resistant depression who had remarkable success with this drug. A nurse practitioner told us that it also helps psychosis though it is not prescribed much in USA for that. We went to 2 psychiatrists who refused to prescribe lithium. It has completely balanced his moods (no surprise), but it also has helped with paranoia, practically stopped the “mean” voices, and reduced voices overall. He used to take 36 mg. of Zyprexa and 50 mg. of Prozac. He has over time reduced to 27 1/2 mg. of Zyprexa and 30 mg. of Prozac.
I can’t fully describe the difference lithium has made, but I would urge everyone who is dissatisfied with their current meds to give it consideration.


a new drug is in trials called luaf357000, it is supposed to be next in line for treatment resistant sz. so its basically a new clozapine. pimavanserin might also work for some people but it is not indicated for treatment resistant sz.

I hope lu af35700 makes it to market im TR and cant take clozapine because of my bloodcount, I have tried so many things and nothing works :frowning: well sarcosine did for abit but i got a real bad pain in my prostate so i was scared to continue it becuase prostate cancer runs in my family.
If anyone knows of anything else thats helpful for TR people please list it here :slight_smile:

i hope things improve for you…you jut have to find the right med

hi! Do you take clozapine for sleep problems? For voices?