Psychotropic drug Clozapine is safe, study suggests

Several studies have hinted at a potential link between the use of clozapine, a highly effectual but largely underused psychotropic drug, and haematological malignancy (HM), but yet little is known about the clinical significance of the potential risk in the absence of analytic cohort studies.

A retrospective cohort study of 18 plus schizophrenia patients using clozapine or olanzapine (drug comparator with highly similar chemical structure and pharmacological mechanisms) was conducted in Hong Kong and the findings were consistent across subgroups by age and sex, showing good specificity to HM but no other cancers.

A two-fold elevated rate of HM was detected in clozapine users but the rate difference between clozapine and olanzapine users was minuscule. The study contends that more restrictive indication for clozapine or special warnings may not be necessary given the rarity of HM and existing blood monitoring requirements. In the absence of randomization, the study didn’t consider underlying factors linked to both clozapine use (versus olanzapine) and HM.

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