I've been on it just over a year (finally down to monthly labs!) and it has probably saved my life. It is highly effective for me. However the side effects are tough and you need to really be committed to it. The main side effects for me are extreme fatigue (I need 10-12 hours of sleep most nights and I fight to fall asleep so I devote a great deal of my life to sleep), heavy drooling in my sleep, mild incontinence in my sleep, and weight gain (20 lbs in first 6 months then it leveled off--but I'm on a med to help with metabolism).

I went on it as a last resort. I had tried every other AAP except Saphris (no insurance coverage) and Invega (allergy to risperidone so presumed allergy to it since it is a metabolite). Older APs aren't an option for me due to problems I've had with other meds. I wouldn't recommend going on it unless it is a last resort because of the side effects and the rare chance of white blood cell issues. The labs are a pain, especially the first 6 months while they are weekly, but that was manageable once it became routine.

If nothing else works for you clozapine is a great last resort drug. I don't know if it is supposed to be highly effective for suicidal ideation. I have not had much on it but everything improved on it so I would expect that. I would have done as my pdoc did and tried everything else possible before going on it (it makes it easier to deal with side effects when you know it's the last option).

On the more positive side if nothing works for you then yes, clozapine is a very, very effective drug and worth trying. When I say it saved my life I'm not exaggerating and it has controlled my bipolar far better than any other drug has done in 19 years of psych meds. I'm so thankful for this drug, even when the side effects are frustrating.

There are a few people on this site on it. The bipolar board is a good place to post since it seems like that is where several of us hang out.