The oldest of the atypicals, it is rarely prescribed because of the need for weekly blood tests for agranulocytosis (not enough white blood cells) and the significant chance of seizures and changes to heart rhythms. Plus you tend to drool like you’re on a standard antipsychotic. The up side is there hardly any chance of getting TD or any extrapyramidal symptoms (EPS) from this med, and may even be a potential treatment for TD. It’s really between you and your doctor if you try this one instead of any of the standard / typical antipsychotics after running through all the other atypicals if you really, really need an antipsychotic. Clozaril blocks a lot of dopamine receptors, and does most of its work in the limbic system, which may explain why TD and EPS are not going to happen. Freakiest rare side effects: complete loss of speech, and the lovely combo of libido increase and priapism. The initial dosage is 12.5 mg once or twice daily and then adding increments of 25-50 mg/day, if well-tolerated, to achieve a target dose of 300-450 mg/day by the end of 2 weeks for schizophrenia. For other ailments you can increase the dose by 100 mg over the course of one or two weeks and see how it goes. The maximum dosage is 500 mg for outpatients, 900 mg for inpatients. Clozaril has a half-life of 12 hours. Novartis.