Which statement about clozapine is true?

Which statement about clozapine is true?

• A. It carries a high risk of agranulocytosis
• B. It has no sedation
• C. It has no metabolic effects
• D. It does not require monitoring

Answer: (A)

Clozapine’s defining safety concern is agranulocytosis, a potentially life-threatening drop in neutrophils that leaves infections a serious risk. Because of this, it requires ongoing hematologic monitoring with regular absolute neutrophil counts. In practice, that's a weekly check for the first six months, then every two weeks for the next six months, and monthly thereafter if counts remain stable. This monitoring burden and risk profile are why clozapine is typically used after other antipsychotics have failed and why a strict monitoring program is in place. It’s also important to recognize why the other statements aren’t true. Clozapine can cause sedation for many patients, and it has metabolic effects such as weight gain, dyslipidemia, and glucose dysregulation. It does not lack these effects, and it does not waive the need for monitoring—quite the opposite, in fact.

Clozapine’s defining safety concern is agranulocytosis, a potentially life-threatening drop in neutrophils that leaves infections a serious risk. Because of this, it requires ongoing hematologic monitoring with regular absolute neutrophil counts. In practice, that's a weekly check for the first six months, then every two weeks for the next six months, and monthly thereafter if counts remain stable. This monitoring burden and risk profile are why clozapine is typically used after other antipsychotics have failed and why a strict monitoring program is in place.

It’s also important to recognize why the other statements aren’t true. Clozapine can cause sedation for many patients, and it has metabolic effects such as weight gain, dyslipidemia, and glucose dysregulation. It does not lack these effects, and it does not waive the need for monitoring—quite the opposite, in fact.