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Considerable progress has been made in the treatment of schizophrenia and other psychotic disorders ever since the discovery of chlorpromazine in the early 1950s and the subsequent discovery of the group of tricyclic chemical compounds including clozapine. On the spectrum of the contemporary pharmacological treatments for schizophrenia, atypical antipsychotic agents render a significant portion. Clozapine continues to play a pivotal role in the treatment of psychotic disorders, despite the emergence of new antipsychotic agents on the market. Among patients with schizophrenia, suicide is the main cause of death. Factors associated with suicide in patients with schizophrenia include previous suicide attempts, inadequate antipsychotic medication, non-compliance, substance abuse and non-response to antipsychotic medication. Clozapine reduces suicidal behavior in patients with schizophrenia. Clozapine has been shown to have a substantial effect on attempted suicide and completed suicide. The mode of action of clozapine in preventing suicide is not known. The various hypotheses proposed include its effects on neurotransmitters, on serum lipid levels, its antidepressant effects or the increased contact with healthcare workers during visits for blood monitoring.

The use of clozapine for the treatment of schizophrenia and implications for suicide prevention