Clozapine-induced paralytic ileus.

Clozapine is an atypical antipsychotic drug with minimal extrapyramidal toxicity, used in the management of patients who are unresponsive or intolerant to at least two different antipsychotics (McEvoy et al. 2006). Ileus is a rare but life-threatening side-effect of clozapine treatment (Palmer et al. 2008). The largest study investigating risk factors of ileus in psychotic patients showed that increasing age and treatment with higher dosage of clozapine were associated with an increased risk of fatal ileus (Nielsen & Meyer 2012). The treatment of clozapine-induced ileus comprises of discontinuation with potential rechallenge of the drug (Palmer et al. 2008). We describe here a patient with treatmentresistant depressive psychosis and extrapyramidal symptoms, who developed paralytic ileus shortly after the initiation of clozapine.