Schizo Relapse After Off Clozapine X Wk

My son is schizophrenia X11 yrs. he takes clozapine 500 mg. risperadone 6 mg, and clonazepam 4 mg. he takes all of this at night and has been for 7 yrs. this past wk he has suffered a MAJOR relapse. I brought him to see his shrink to day and he ups his risperadone to 8 mg. My son sets up his meds in a wk long med box, I check them just by counting the pills and knowing the colors. As I was preparing his meds tonight I noticed there were an awful lot of clozapine left in the bottle. Upon further checking I realized he had been taking 5 (1mg) tablets of clonazepam instead of clozapine! The 2 pills almost are identical. So he was accidentally off his clozapine for 1 wk, this explains his super bad relapse. I decided to give him 100mg of cloz(instead of his usual 500mg dose) he ways 250lbs. I also gave him 4mg clonazepam and 6 mg risperdol. This was around 12:30 am. I checked on him about 30 min later and he was Sleeping (?), Resp shallow pulse weak. It was ver difficult to wake him but he finally was aroused and I helped him walk to family room recliner where I could watch him. I called poison control and they said he looked like he would be ok "on paper" so I'm sitting here watching him breathe and he is very difficult to arouse even to open his eyes. I am worried. I hope someone is awake that can chat with me. I didn't call his dr 'cause he wouldn't be any help (long story). So my question is do you think giving him clozapine 100mg (he normally takes 500 mg, but was off for a week) was too much to give? Cloz peaks in about 21/2 hrs which is about now.

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Hello, Patricia! How is your son doing?

If his Risperidone was raised, that is most likely what's causing this. It's a very potent antipsychotic and is very well known to cause extreme sedation and somnolence. The shallow breathing, sleepiness and etc. are all known side effects of it, as listed by the FDA.

It may be too high of a dose and it may need to be lowered back down and he likely needs to start taking his Clozapine, again.

Is he doing any better?

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Hi Verowon,
Thanks for responding. My initial post was so long...I was very frazzled that night. I wasn't concerned about any Of the meds except clozapine. He usually takes 500mg/day, but had inadvertently not taken it for 7 days. I just did not know how to restart the dose on clozapine. I started with 100mg which I believe was too much (since he did not have any in his system) I had not yet increased his risperadone since I was getting him back on his clozapine . I spoke with jus shrink at 7 a.m. and he told me just give him the whole 500mg clozapine at once. Nope, didn't do that. I have gradually increased his clozapine he is on 400 mg as of tonight. He is doing better, physically he is fine. I need to find a psychiatrist I can trust. Thank you agai !

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