Clozapine is a gold standard medication and drug of choice in refractory schizophrenia. Among many of its fatal side effects, delirium is less reported and inconsistently recognized by clinicians. We here present a case of delirium which emerged during retreatment with clozapine in a patient of paranoid schizophrenia. A patient diagnosed with paranoid schizophrenia, was restarted on clozapine a...

Clozapine is known to cause innocuous as well severe and or fatal cardiovascular side effects. These effects are commonly reported at the initiation of clozapine therapy. We report a patient who was stable on for several years but in whom we had withhold medical reasons subsequently developed significant hypotension heart rate changes when rechallenged with small dose clozapine.

OBJECTIVE To determine the relation between serum clozapine and nor-clozapine levels and blood cell counts during clozapine treatment. METHOD We undertook a prospective longitudinal study of 37 consecutive patients with a diagnosis of schizophrenia treated with clozapine. We obtained informed consent and then determined serum concentrations of clozapine and nor-clozapine weekly. Clozapine was...

BACKGROUND Data on the haematological outcomes of patients who continue clozapine treatment following neutropenia are very rare as even mild neutropenia results in mandatory discontinuation of clozapine in most countries. However, in Iceland where clozapine monitoring is less stringent allows an observational study to be done on the risk of agranulocytosis and neutropenia during treatment with ...

Sir: Approximately 70% of clozapine metabolism is explained by the cytochrome P450 1A2 (CYP1A2). The CYP1A2 can be inhibited by respiratory infections. Decreased theophylline (a CYP1A2 substrate) clearance during upper respiratory infections has been described in asthmatic children and in adults with chronic bronchitis. Cytokines released during infection decrease CYP1A2 activity and synthesis....

Sir: Approximately 70% of clozapine metabolism is explained by the cytochrome P450 1A2 (CYP1A2). The CYP1A2 can be inhibited by respiratory infections. Decreased theophylline (a CYP1A2 substrate) clearance during upper respiratory infections has been described in asthmatic children and in adults with chronic bronchitis. Cytokines released during infection decrease CYP1A2 activity and synthesis....

Background The atypical antipsychotic clozapine is effective in treatment-resistant schizophrenia; however, the success or failure of clozapine therapy is substantially affected by the variables that impact the clozapine blood concentration. Thus, elucidating the inter-individual differences in clozapine pharmacokinetics can facilitate the personalized therapy. Methods Since a potential role ...

Covalent binding of a reactive metabolite of clozapine to neutrophils or their precursors is thought to play a role in the development of clozapine-induced agranulocytosis. Immunoblotting studies with an anti-clozapine antiserum detected covalent binding of clozapine to human neutrophils in vitro when HOCl was used to generate clozapine reactive metabolite (major clozapine adducts of 31, 49, 58...