A case of abnormally increased clozapine plasma concentration caused by ileus and infections in a patient with schizophrenia
10.3760/cma.j.cn113661-20220703-00174
- VernacularTitle:精神分裂症患者肠梗阻合并感染致氯氮平血药浓度异常增高1例
- Author:
Yi GU
1
;
Qijing BO
1
;
Yanfang ZHANG
1
;
Tian LI
1
;
Chuanyue WANG
1
Author Information
1. 首都医科大学附属北京安定医院 精神疾病诊断与治疗北京市重点实验室 国家精神心理疾病临床医学研究中心 北京脑重大疾病研究院精神分裂症研究所，北京100088
- Publication Type:Journal Article
- Keywords:
Schizophrenia;
Intestinal obstruction;
Clozapine;
Infection;
Leukopenia;
Plasma concentration
- From:
Chinese Journal of Psychiatry
2023;56(3):227-231
- CountryChina
- Language:Chinese
-
Abstract:
A 51-year-old schizophrenic patient with long-term clozapine treatment developed intestinal obstruction combined with infection. Subsequently, the patient′s clozapine plasma concentration abnormally increased to 3 094.80 μg/L (reference range 350-600 μg/L), accompanied with pulmonary infection. Patient′s symptoms showed significant improvement after clozapine was discontinued, along with intravenous fluid reinfusion and antibiotic treatment. This current article also provided a literature review of 16 reported cases of infection with abnormally elevated clozapine plasma concentration. Clozapine plasma concentration and blood routine should be monitored in clozapine users, and adverse reactions should be treated in time. For clozapine users with infection but normal leukocyte count, multiple bacterial infection indicators such as the neutrophil proportion and C-reactive protein should begiven comprehensive consideration, and antibiotics should be used when appropriate. If clozapine plasma concentration is abnormally high, clozapine can be discontinued and intravenous fluid reinfusion can accelerate clozapine elimination. After the patient′s condition stabilizes, clozapine could be reused.
