<prompt> Not true about clozapine is:Should be discontinued, if WBC counts 3500dlHas no anti suicide propeyShould not be used along with carbamazepineThe action is more on D4 receptors than D2 receptors  <response>: Clozapine: It is a DOC for treatment resistant schizophreniaTRS TRS is defined as lack of response to 2 antipsychotics atleast 1 atypical at adequate dose for atleast 4-6 weeks It has more affinity for D4 receptors , less affinity for D2- ? minimum EPS. It has anti- suicide propey It is an antipsychotic agent with maximum weight gain propey. Side effects: most common- sedation due to H1 blocking propey Sialorrhea Syncope, hypotension, tachycardia, nausea and vomiting Anticholinergic side effects like constipation Three life threatening side effects: AgranulocytosisIdiosyncratic Myocarditis SeizuresDose dependent Monitoring: TLC and ANC Once a week for first 6 months Once in two weeks for next 6 months Once a month till patient is on clozapine If WBC count falls below 3000dL or ANC falls below 1500dL, STOP the clozapine. Contraindications: WBC 3500dL History of agranulocytosis on clozapine Use of bone marrow suppressants such as carbamazepine. 