 |
Case Report
Rarer adverse effect of clozapine
1 Resident, Department of General Medicine, Dr. Ram Manohar Lohia Hospital, New Delhi, India
2 Professor, Department of General Medicine, Dr. Ram Manohar Lohia Hospital, New Delhi, India
Address correspondence to:
MB Indu
Resident, Department of General Medicine, Dr. Ram Manohar Lohia Hospital, New Delhi,
India
Message to Corresponding Author
Article ID: 101315Z01MI2022
Access full text article on other devices
Access PDF of article on other devices
How to cite this article
Indu MB, Saini R, Sharma B. Rarer adverse effect of clozapine. Int J Case Rep Images 2022;13(1):24–27.ABSTRACT
Introduction: Clozapine is an atypical anti-psychotic drug widely used in the treatment of schizophrenia. It reduces suicidal ideations in schizophrenics and hence the mortality. Agranulocytosis is one among the most known serious complication of this drug. However, it can also cause life-threatening complications like necrotizing enterocolitis.
Case Report: We report a case of a 31-year-old male with past history of schizophrenia and seizure disorder on 300 mg clozapine and phenytoin 300 mg daily for 10 years. He was admitted for the evaluation of altered sensorium. Blood routine investigations and radioimaging were normal. Electroencephalogram (EEG) showed non-convulsive status epilepticus which was managed with anti-epileptic drugs. His sensorium did not improve. He started to develop fever and loose stools, later developed abdominal distension and pain. On evaluation it was found to have ischemic colitis with secondary bacterial peritonitis. Clozapine was stopped, managed conservatively. The patient recovered completely.
Conclusion: Clozapine can cause seizures. The anti-cholinergic effect of this drug can induce focal intestinal necrosis, which when unrecognized progress to transmural ischemia and perforation. Such cases need surgical intervention and is associated with high mortality. A high index of suspicion for early diagnosis, prompt correction of risk factors and early intervention prevents mortality.
Keywords: Clozapine, Ischemic colitis, Non-convulsive seizures
SUPPORTING INFORMATION
Author Contributions
MB Indu - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Rohit Saini - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Brijesh Sharma - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 MB Indu et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
