A schizophrenic patient was prescribed drug A after he did not respond to haloperidol and thioridazine. He now presents with excessive salivation, an increase in blood glucose, and hyperlipidemia. What is drug A?

Options

Ziprasidone
Risperidone
Clozapine
Aripiprazole

Correct Answer

Clozapine

Explanation

Clozapine is the gold standard for treatment-resistant schizophrenia (failure of two antipsychotics including one atypical). The side effects mentioned are characteristic of clozapine: 1) Hypersalivation (sialorrhea) - very common and bothersome, 2) Metabolic syndrome - weight gain, hyperglycemia, dyslipidemia, 3) Other serious side effects: agranulocytosis (requires weekly CBC monitoring initially), seizures (dose-dependent), myocarditis. Despite side effects, clozapine is the most effective antipsychotic for treatment-resistant cases and reducing suicidal behavior.

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