Clozapine: seizures: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Clozapine: seizures

Sample item

A patient on clozapine 600 mg per day has a generalised seizure. Which statement is correct?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Seizure risk is dose-dependent and rises above about 600 mg

Clozapine lowers the seizure threshold in a dose-related fashion, with risk of about 5 percent at doses over 600 mg per day. Dose reduction, slower titration and adding valproate may be needed. Carbamazepine is avoided because of additive bone marrow toxicity.

Option by option

  • A. Seizure risk is independent of dose

    The risk is dose-related.

  • B. Seizure risk is dose-dependent and rises above about 600 mg (correct)

    Correct. Seizure risk climbs with dose, notably above 600 mg.

  • C. Seizures occur only after abrupt withdrawal

    Seizures can occur on treatment and not only after withdrawal.

  • D. Clozapine has the lowest seizure risk among antipsychotics

    Clozapine has one of the highest seizure risks among antipsychotics.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is B, Seizure risk is dose-dependent and rises above about 600 mg. Clozapine lowers the seizure threshold in a dose-related fashion, with risk of about 5 percent at doses over 600 mg per day.

Why is "Seizure risk is independent of dose" not the answer?

The risk is dose-related.

Why is "Seizures occur only after abrupt withdrawal" not the answer?

Seizures can occur on treatment and not only after withdrawal.

Why is "Clozapine has the lowest seizure risk among antipsychotics" not the answer?

Clozapine has one of the highest seizure risks among antipsychotics.

What concept does this question test?

It tests Clozapine: seizures in Psychiatry. Dose reduction, slower titration and adding valproate may be needed. Carbamazepine is avoided because of additive bone marrow toxicity.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Clozapine: seizures?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.