Devinsky O, Pacia S V
Department of Neurology, New York University School of Medicine, NY 10003.
J Clin Psychiatry. 1994 Sep;55 Suppl B:153-6.
Seizures are an important adverse effect of clozapine therapy; a cumulative 10% risk of tonic-clonic seizures is estimated after 3.8 years of treatment. Although the risk of seizures may be increased by rapid upward titration and higher doses, recent data do not clearly confirm the dose-dependent effect. The vast majority of clozapine-related seizures are tonic-clonic, although myoclonic seizures also occur. The role of the EEG in predicting the occurrence of clozapine-induced seizures remains uncertain. In patients with clozapine-related seizures, either reducing the dose or adding an antiepileptic medication usually allows continuation of therapy.
癫痫发作是氯氮平治疗的一种重要不良反应；据估计，治疗3.8年后，强直阵挛性癫痫发作的累积风险为10%。虽然快速上调剂量和较高剂量可能会增加癫痫发作风险，但近期数据并未明确证实剂量依赖性效应。氯氮平相关癫痫发作绝大多数为强直阵挛性发作，不过也会出现肌阵挛性发作。脑电图在预测氯氮平诱发癫痫发作方面的作用仍不确定。对于氯氮平相关癫痫发作的患者，减少剂量或加用抗癫痫药物通常可使治疗得以继续。
