• Pietro Gareri, Pasquale De Fazio, Emilio Russo, Norma Marigliano, Salvatore De Fazio, and Giovambattista De Sarro.
• University "Magna Graecia" of Catanzaro, "Mater Domini" University Hospital, Clinical Pharmacology and Pharmacovigilance Unit, Faculty of Medicine and Surgery, Department of Experimental and Clinical Medicine, Catanzaro, Italy. pietro.gareri@alice.it
• Expert Opin Drug Saf. 2008 Sep 1; 7 (5): 525-38.

BackgroundClozapine was the first atypical 'broad spectrum' antipsychotic drug to be marketed and the first agent approved for the treatment of schizophrenia refractory to other medications. It is also effective for the treatment of aggressive behaviour in schizophrenic and demented patients and in the management of psychosis and aggression in Parkinson's disease and Lewy body dementia.ObjectiveThe aim of this review is to study the safety of clozapine for use in elderly patients.MethodsAn extensive Medline search was made. Some studies that were referenced in reports from our pharmacovigilance centre and from regulatory agencies such as the FDA, EMEA and WHO were included.ConclusionsClozapine treatment in the elderly requires a careful geriatric assessment. However, its use is strongly limited by the possibility of onset of severe adverse effects such as potentially fatal agranulocytosis, myocarditis and others such as seizures, weight gain and metabolic adverse effects.

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