Can clozapine cause tremor?

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From the FDA Drug Label

CNS reactions, including sedation, dizziness/vertigo, headache, and tremor; Table 10 summarizes the adverse reactions reported in clozapine-treated patients at a frequency of 2% or greater across all clozapine studies... Tremor 6 Advise patients that clozapine may cause extrapyramidal and/or withdrawal symptoms (agitation, hypertonia, hypotonia, tremor, somnolence, respiratory distresss, and feeding disorder) in a neonate

Yes, clozapine can cause tremor 1.

From the Research

Clozapine is not typically associated with causing tremor, but rather has been shown to improve tremor symptoms in certain conditions, such as Parkinson's disease and essential tremor, as evidenced by studies including 2 and 3.

Key Points to Consider

  • The effects of clozapine on tremor are complex and can vary depending on the individual and the specific condition being treated.
  • Studies have demonstrated that clozapine can significantly reduce tremor symptoms in patients with Parkinson's disease and essential tremor, with benefits seen at relatively low doses, as reported in 2 and 3.
  • The mechanism behind clozapine's antitremor effects is not fully understood but is thought to involve its unique pharmacological profile, including its anticholinergic properties and effects on dopamine receptors.
  • While clozapine is generally well-tolerated, it can cause side effects, including sedation, hypersalivation, and daytime drowsiness, as noted in 4 and 3.
  • Regular blood monitoring is required for patients taking clozapine due to the risk of agranulocytosis, a potentially life-threatening decrease in white blood cells, as highlighted in 4 and 3.

Clinical Implications

  • Clozapine may be considered as a treatment option for patients with tremor-predominant Parkinson's disease or essential tremor who have not responded to other treatments.
  • Patients should be closely monitored for side effects and undergo regular blood tests to minimize the risk of agranulocytosis.
  • The decision to use clozapine should be made on a case-by-case basis, taking into account the individual patient's medical history, current symptoms, and potential risks and benefits, as discussed in 5.

References

Research

Acute and chronic effects of clozapine in essential tremor.

Movement disorders : official journal of the Movement Disorder Society, 1999

Research

Clozapine in the treatment of tremor in Parkinson's disease.

Acta neurologica Scandinavica, 1994

Research

Clozapine in the treatment of tremor.

Acta neurologica Scandinavica, 1986

Research

Atypical antipsychotics in the treatment of drug-induced psychosis in Parkinson's disease.

Movement disorders : official journal of the Movement Disorder Society, 2000

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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