Severe acute pancreatitis, neuroleptic malignant syndrome and grand mal seizures associated with elevated amisulpride and low clozapine serum levels.

Acute pancreatitis, neuroleptic malignant syndrome (NMS) and epileptic seizures are all known to be rare complications of clozapine-treatment (Steinert et al. 2011, Tenner 2014, Belvederi Murri et al. 2015). For amisulpride, only seven cases with NMS (Belvederi Murri et al. 2015) including one case with seizures (Musshoff et al. 2013) have been described yet. Recently, via a German pharmacovigilance project 4 schizophrenic adults being treated with amisulpride (600-1200 mg/d) and showing an elevation of their creatinine kinase (CK, ranging from 1500 U/l to 21000 U/l) were found, who suffered from myalgia without signs of NMS and whose myalgia and CK elevation were reversible after amisulpride discontinuation (Laoutidis et al. 2015). An amisulpride-related pancreatitis is not reported to the authors` best knowledge. Hereinafter, we report a patient treated with amisulpride and clozapine, who fell into a critical condition characterized by severe acute pancreatitis, NMS and seizures.