ReviewFrontiers in endocrinology2021
A Focused Review of the Metabolic Side-Effects of Clozapine.
Review in Frontiers in endocrinology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 3 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Systematic review and meta-analysis of the effects of EEG neurofeedback combined with pharmacological treatment on the positive and negative symptoms in patients with schizophrenia.Frontiers in psychiatry · 2025Pooled it
- A systematic review and meta-analysis of synthetic cathinone use and psychosis.Psychopharmacology · 2024Pooled it
- A Guideline and Checklist for Initiating and Managing Clozapine Treatment in Patients with Treatment-Resistant Schizophrenia.CNS drugs · 2022Guideline
- Review
- Xanomeline-Trospium Validates Muscarinic Agonism as an Effective Non-Dopaminergic Treatment for Schizophrenia.International journal of molecular sciences · 2026Review
- Risk of Long-Term Clozapine Medication over Decades for Cardiac Adverse Events Including Heart Failure and Its Pathophysiology: A Japan and China Retrospective Cohort Analysis.Medical sciences (Basel, Switzerland) · 2026Article
- Longitudinal brain structural changes during clozapine treatment: associations with neuroreceptor architecture and clinical response.medRxiv : the preprint server for health sciences · 2026Article
- Risk factors for sudden cardiac death or sudden unexplained death in patients treated with clozapine: systematic review.BJPsych open · 2026Review
- Adiponectin improves clozapine-induced lipid accumulation and inflammation without affecting insulin resistance.Open life sciences · 2026Article
- Intracranial hypertension after MECT: successful transition to rTMS for refractory auditory hallucinations: a case report.Frontiers in psychiatry · 2026Article
- Atypical antipsychotics alter microglial functions via astrocyte-derived extracellular vesicles.Brain, behavior, and immunity · 2026Article
- GLP-1 Receptor Agonists in Mood Disorders: A Psychiatric Perspective.Life (Basel, Switzerland) · 2025Review
- Comparing the Metabolic, Systemic, and Neuropsychiatric Impacts of Olanzapine and Clozapine in Patients with Schizophrenia.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Accessing the viscera: Technologies for interoception research.Current opinion in neurobiology · 2025Review
- Clozapine-Related Tachycardia: An Analysis of Incidence.CNS drugs · 2025Article
- Exploring Proteomic Alterations in Intellectual Disability: Insights from Hyperlipidemia and Hyperphosphatasia Subgroups.Neuromolecular medicine · 2025Article
- Rare but elevated incidence of hematological malignancy after clozapine use in schizophrenia: A population cohort study.PLoS medicine · 2024Article
- Manipulation of Lipid Nanocapsules as an Efficient Intranasal Platform for Brain Deposition of Clozapine as an Antipsychotic Drug.Pharmaceutics · 2024Article
- Rethinking Clozapine: Lights and Shadows of a Revolutionary Drug.Brain sciences · 2024Review
- The Prevalence of Hyperuricemia and the Association Between Hyperuricemia and Age in Patients with Psychiatric Disorders to a General Hospital: A Cross-Section Study.International journal of general medicine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The second generation antipsychotic drug clozapine represents the most effective pharmacotherapy for treatment-resistant psychosis. It is also associated with low rates of extrapyramidal symptoms and hyperprolactinemia compared to other antipsychotic drugs. However, clozapine tends to be underutilized in clinical practice due to a number of disabling and serious side-effects. These are characterized by a constellation of metabolic side-effects which include dysregulation of glucose, insulin, plasma lipids and body fat. Many patients treated with clozapine go on to develop metabolic syndrome at a higher rate than the general population, which predisposes them for Type 2 diabetes mellitus and cardiovascular disease. Treatments for the metabolic side-effects of clozapine vary in their efficacy. There is also a lack of knowledge about the underlying physiology of how clozapine exerts its metabolic effects in humans. In the current review, we focus on key studies which describe how clozapine affects each of the main symptoms of the metabolic syndrome, and cover some of the treatment options. The clinical data are then discussed in the context of preclinical studies that have been conducted to identify the key biological substrates involved, in order to provide a better integrated overview. Suggestions are provided about key areas for future research to better understand how clozapine causes metabolic dysregulation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.