A case report of a schizophrenia patient with clozapine intoxication
10.3760/cma.j.cn113661-20231129-00232
- VernacularTitle:精神分裂症患者氯氮平中毒1例
- Author:
Yunan LIN
1
;
Xiao JI
1
Author Information
1. 首都医科大学附属北京安定医院，北京100088
- Publication Type:Journal Article
- Keywords:
Schizophrenia;
Clozapine;
Cytochrome P-450 enzyme system;
Blood concentration;
Roukou sishen wan
- From:
Chinese Journal of Psychiatry
2024;57(9):620-622
- CountryChina
- Language:Chinese
-
Abstract:
This case report presents a patients with stable schizophrenia who abruptly vomited for three days during long-term treatment of clozapine. Laboratory tests revealed a blood clozapine concentration of 2 826.54 ng/ml (three times higher than the warning threshold). The intoxication of clozapine was cured after a week of intensive psychiatric emergency care, including promoting metabolism-promotion infusion and symptomatic and supportive treatment. A comprehensive review of the patient′ medical history, laboratory results, and symptoms led to the identification of the concurrent use of Roukou Sishen Wan, a traditional Chinese herbal medicine that modulated Bowel problems and diarrhea. Several components of Roukou Sishen Wan could interact with cytochrome P450 (CYP450), potentially disturbing clozapine metabolism and causing the elevated blood clozapine concentration. Based on these findings, clinicians are strongly recommended to exercise caution when prescribing combination therapies. The drug interaction should be considered when encountering unexpectedly high blood clozapine levels during routine clozapine treatment with stable doses.
