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The range of side effects from psychiatric drugs is immense. On the leaflets that come with any drug box
the companies are legally obliged to list any and all the potential adverse effects that their product might
create. It is quite common to see over a hundred different things mentioned. The most common side effects
are listed first, with the least likely at the bottom, and so on, in the ubiquitous leafleats. As per usual I give
things I have personally experienced in alphabetical order, rather than order of importance.
EJACULATIO I only get this problem with Clozaril, but it happens invariably. Basically if you
have taken your dose of this stuff, and you indulge in sexual activity, you can have an orgasm but you will
not cum (ejaculate). This happens quite often, and I really wonder if it does my ‘plumbing’ any permanent
EYE PROBLEMS Although I cannot directly prove that the psychiatric medication has given me eye
problems, it is quite likely. Until eight or nine years ago I have perfect 20/20 vision. In fact I used to freak
people out I had such excellent vision. Now I am short sighted, with what the optician diagnosed as
astigmatism. I also get very bad ‘floaters’ which can only be described as lights, circles and chains that
cross my field of vision – especially when I look at the daytime sky, or something like a white washed wall
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or ceiling. If this wasn’t enough I sometimes get a vortex type thing, that pulsates with black and white
patterns, and is kind of like a dimensional gateway! I know it sounds weird!
I am supposed to wear glasses, but knowing that they make my eyes weaker, and this very quickly, I
generally only use them when watching movies or when I travel.
HALLUCI ATIO S Although the strongest psychiatric hallucinogen is undoubtedly Procyclidine
Hydrochloride, I have also had a trip or two with Lorazepam, although this was because of overdose. The
most frequent hallucination is seeing things move – as if they were alive! I struggled for an adjective to
describe this shifting and contorting of things until someone suggested ‘breathing’; this to date is the most
accurate portrayal. This is very common with Procyclidine, but with Lorazepam overdose I also
experienced seeing my own reflection change (this was quite demonic), my mirror ‘breathe’ up and down
the wall, my Charlotte Church calendar become alive and so on. It should be added that it is quite easy to
cope with seeing objects ‘breathe’ but when people start to contort it can be very scary. (There is a
hallucination program available online nowadays that provides the same identical ‘breathing’ effect, but
LIBIDO PROBLEMS For me the worst side effect is a reduced libido. This for me is the case with
Lorazepam, Clonazepam, Temazepam, Clopixol, Haliperidol and probably scores of others. This may be a
reason why the little blue pills, the Lorazepam, is given to just about every patient in Forston and to a lesser
extent Linden. When I was on Clopixol depots I was once completely unable to get an erection with a very
sexy woman; eventually I did get one – but then had premature ejaculation! Clopixol was the worst drug in
MOVEME T DISORDERS There are several types of movement disorder generally associated
with antipsychotics, typical, atypical and novel. My first run in was with Olanzipine, otherwise known as
Zyprexa. To this day I do not know why I tolerated those symptoms for all those months. Basically, I
would take my Olanzipine at night, go to bed, and look forward to a good hour or two of torture. I believe
the doctors refer to what I experienced as a ‘dystonic reaction’, but forgive me if I am wrong. If felt like a
nervous spasm, an uncontrollable surge of energy, akin to a self generated electric shock! I would feel it in
my feet, but sometimes by wrists and hands as well. The energy would rise, every 40 seconds or so, and I
would be forced to shake my leg for a temporary alleviation of the excess nervous force. But it would go on
for quite a while, every night. (Eventually I stopped taking my meds because of it, and relapsed because of
neurolyptic withdrawal symptoms.) To not respond to the nervous surges, and keep still, took almost as
much willpower as it would take for one to hold one’s hand over a candle flame. It was fucking horrible. I
got these symptoms to a lesser extent with Clozaril, and when I overdosed on the benzodiazepines.
Eventually I was put on a beta blocker called Metroprolol to combat the dystonia. This helped not
inconsiderably but made me out of breath – another side effect.
Another movement problem I got, from Clopixol, was something called ‘tardive dyskinesia’. This
manifested mainly in my legs and feet. It was nothing like the dystonic nerve spasms mentioned above.
You know some people have a habit of putting their feet on the paddy area below the toes, and kind of like
hitting the nervous resonance of the Achille’s Heel? So that the leg moves of its own accord? Well
basically I was doing that, but most of the waking day! People would remark on how annoying it was – but
I couldn’t stop! This was mainly a problem with the Clopixol dept injections; eventually it got so annoying
that I was put on Risperdal Consta depots, with the promise that it would diminish. But it didn’t! Now I am
on Clozaril tablets and the T.D. has more or less gone away. Thank God for that!
Last but not least in the movement disorder category we have the ‘crisis’. This is a result of Clopixol
Acuphase or Haliperidol injections. Basically you have the milder version where the head twists back, and
it is difficult to speak clearly. The more serious type involves complete muscular seizure, eyes rolling back,
difficulty breathing and sometimes even death. If you get this on a ward you will be given liquid
Procyclidine, or an injection of the same. Because Proyclidine gives you quite a buzz I have even known
people, including myself, to fake the above symptoms. I am not sure if this is true for anyone except me,
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but I did seem to develop a natural immunity over time for the ‘crisis’.
ODOURS This side effect can be subdivided into actual odours coming through one’s skin, and
olfactory hallucinations associated with withdrawal from antipsychotics.
I found when reducing my dose of benzodiazepines (definitely Lorazepam and Clonazepam, and maybe –
but I am not certain – Temazepam) that a strange, toxic and really pretty foul smell would be sweated out of
my skin; especially through the armpits and groin. My girlfriend at the time noticed this and she was
genuinely disgusted – I tried to explain it was the meds, but this didn’t cut the mustard with her. It may
have been a contributing factor to our split up. I cannot describe the smell and cannot accurately compare it
with anything else. It was vile. And guess what? When the benzos were out of my system the terrible
But possibly worse than this is the olfactory hallucination… My worst experience of this was when I was
homeless elsewhere in Dorset. It was kind of like a cross between damp and rotting clothing, rotten flesh,
and radioactive God knows what. On one occasion I ended up burning down my tent (and all my
possessions at the time) because the ‘smell’ was so bad. I only got this when I rapidly withdrew my dose of
Clozaril, and got it to a lesser extant by a similar withdrawal from Clopixol. In both cases the ‘smell’
followed me around for days, even onto the psychiatric ward! Trust me it isn’t nice.
OVERSLEEPI G This is a big problem with Clozaril. It is not uncommon for someone even on a
mild dose to sleep for at least twelve hours a day. Generally you can get by on nine or so hours, but the
drug just makes it very appealing to get back into the sack. So, although it is a problem, it shouldn’t be any
trouble for someone with an obligation to get up in the morning, such as someone with a job etc.
On a lesser note, the benzodiazepines, if taken during the day can make you go to sleep during the day
sometimes. This was definitely the case on Minterne ward. I noticed that I would sleep less during the day
as the dose was reduced.
WEIGHT GAI This is a real bummer for me. Clozaril is the worst antipsychotic when it comes to
weight gain, without a doubt. It doesn’t actually pile the flab on of its own accord, but it increases one’s
appetite significantly. Quite often, if one takes one’s dose before sleeping, one gets hungry about two hours
after taking it; and often enough one has a large breakfast also. When I was first put on Clozaril it was in
the days before Minterne became a PICU (Psychiatric Intensive Care Unit), and one could eat as much as
one wanted. I took advantage of this and consumed massive amounts of stodgy grub. I was not exercising
much (my natural burn off technique is to walk and one only walked around the grounds a few times before
boredom set in) and put on something like six stone in as many months. This also left me permanently
scarred with stretch marks over different parts. At the moment I am about 20 stone.
When I was put on Clopixol, and later Risperdal Consta, the weight eventually dropped off. However, I
think in retrospect the best medication is still Clozaril because, although you might become fat, you will not
be left with a socially alienating movement disorder – you can always lose the weight later, or do sport etc.
For example’s sake I include, verbatim, the side effects associated with Clozaril, taken directly from the
leaflet that comes in the pill box:
POSSIBLE SIDE EFFECTS
Effects on blood
Clozaril can cause changes to the numbers of a type of cell (white cell) which is found in the blood.
Occasionally, people may develop a decrease in a particular type of white blood cell called a neutrophil.
eutrophils are responsible for fighting infections and so, if they decrease, you body may be less able to
fight off infection. You may hear this called ‘neutropenia’ or ‘agranulocytosis’. It is for this reason that
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regular blood tests must be carried out. If a significant decrease in white blood cells occurs, further blood
tests will be necessary and if at any point, the level of white blood cells drops below a certain level,
Clozaril treatment must be stopped straight away. It is very important to miss blood tests. Once Clozaril
has been stopped, the white blood cells should recover. In you develop neutropenia or agranulocytosis,
you will not be able to receive Clozaril again. While you are taking Clozaril, it is important that you tell
doctor immediately if you develop any sign of infection, such as an increase in temperature, or symptoms
like flu or a sore throat. This will allow your doctor to perform an urgent blood test in order to check
whether your symptoms are related to your medicine. Occasionally, Clozaril can cause an increase in the
number of white blood cells. Additionally, Clozaril may also cause an increase in a specific type of white
blood cell called an eosinophil. If it rises above a certain level, Clozaril treatment will be stopped.
Clozaril will only be restarted when the number of eosinophils has dropped. A decrease in the number of
platelets (a blood cell essential for the clotting of blood) has also occurred in some very rare cases. If the
number of platelets falls below a certain level, Clozaril treatment will be stopped. An increase in the
number of platelets can also occur.
Effects on the heart
Rarely, Clozaril has been reported to adversely affect the heart. For this reason, before you start taking
Clozaril, your doctor will ask you about any previous heart problems you may have had and will carry out
a physical examination that might include a trace recording of the heart (electrocardiogram or ECG).
Clozaril can cause changes to the ECG, palpitations and an altered heart rhythm. Rarely, it can cause
abnormalities of the heart muscle (cardiomyopathy), inflammation of the membrane surrounding the heart
muscle (peridcarditis), fluid collection around the heart (pericardial effusion) and very rarely cardiac
arrest. It has also rarely been reported to cause inflammation of the heart muscle (myocarditis). If
myocarditis occurs, it usually happens within the first two months of treatment. Symptoms of myocarditis
may include; a fast heartbeat at rest, fast or difficult breathing, chest pain, palpitations, an abnormal heart
rhythm, flu symptoms, unexplained fatigue and raised eosinophils in the blood. If you have taken Clozaril
in the past and been diagnosed with myocarditis it is very important that you inform your doctor, since you
should not take Clozaril again.
Other Side Effects
In some people Clozaril may cause the following:
Making extra salive (spit) or drooling
Faintness or light headedness if you stand up suddenly after lying down
Tremor, rigidity, agitation, restlessness and abnormal movements
Epileptic fits (seizures, convulsions) and jerking
Raised body temperature – especially in the initial weeks of treatment
High blood pressure
Feeling of sickness, vomiting, loss of appetite
Involuntary loss of urine or difficulty in passing urine
Minor abnormalities in liver function tests
euroleptic Malignant Syndrome ( MS) – a severe reaction to antipsychotic medication
Some patients may develop constipation whilst taking Clozaril which may become severe.
This should be reported to your doctor as treatment may be necessary.
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On rare occasions CLOZARIL may cause:
Raised blood sugar levels and sugar diabetes. Very rarely, some patients can be severely
Confusion or disorientation
Abnormal muscle movement of face and limbs
Raised levels of a type of fat (triglyceride) in the blood
Clotting in the blood vessels e.g. legs
Difficulty in swallowing
Difficulty in breathing
Accidental inhalation of food
Severe constipation associated with obstruction of the bowel which may cause abdominal
pain and stomach cramps
Inflammation of the liver, and other effects on the liver, causing yellowing of the skin, itching
and dark urine
Inflammation of the pancreas leading to abdominal pain
Enlargement of the glands that produce salive
Inflammation of the kidneys
Raised levels of an enzyme called creatinine phosphokinase in the blood
Painful persistent erection of the penis
High cholesterol levels in the blood
Anaemia (low haemoglobin)
Tell your doctor straight away if you experience any of the above symptoms or if you have any other
unexpected symptoms not mentioned in this leaflet.
Unless your doctor advises you otherwise, you should not stop taking your Clozaril tablets suddenly
because there have been reports of withdrawal reactions following sudden cessation of therapy. These
reactions include sweating, headache, nausea, vomiting, diarrhoea and reoccurrence of your original
symptoms e.g. thought disorders.
Very rarely, sudden unexplained deaths have been reported in patients taking Clozaril. Such deaths are
known to occur among people with psychiatric disorders whether they are on treatment or not.
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