Clozapine and seizure risk: primary or secondary prophylaxis?

Clozapine is licensed for treatment‐resistant schizophrenia. Clozapine dosage is normally adjusted according to each patient's clinical response and the side‐effect profile, but caution is advocated when using clozapine, due to its association with potentially life‐threatening side‐effects. One such adverse reaction is the risk of seizures. There is much debate as to how to prevent clozapine‐induced seizures: some authors recommend primary and some, secondary prophylaxis with antiseizure drugs. This article highlights an interesting case study and explores various factors that must be considered before a decision is made to prescribe anticonvulsant medication.