Relationship Between Clozapine Levels and Acute Inflammatory Stress.

Abstract

Stress-induced changes in pharmacokinetics can significantly alter the plasma levels of some drugs such as clozapine. This report describes the case of a middle-aged man with schizoaffective disorder, bipolar type who showed sustained elevation in clozapine levels 3 days after discontinuation. Before the clozapine levels were drawn, he had developed acute bacterial pneumonia and signs of acute bacterial meningitis followed by neuroleptic malignant syndrome after he received multiple doses of intravenous haloperidol for worsening psychosis and aggressive behavior. Existing literature on this topic is also reviewed to investigate potential reasons for sustained clozapine levels during acute inflammatory stress and neuroleptic malignant syndrome.

• Authors: Abigail Wagner, Mujeeb U Shad
• Journal: The primary care companion for CNS disorders (Prim Care Companion CNS Disord) Vol. 22 Issue 4 (Jul 02 2020) ISSN: 2155-7780 [Electronic] United States
• PMID: 32628372 (Publication Type: Case Reports, Journal Article)
• Copyright: © Copyright 2020 Physicians Postgraduate Press, Inc.

Chemical References

• Antipsychotic Agents
• Clozapine

Topics

• Acute Disease
• Antipsychotic Agents (blood)
• Clozapine (blood)
• Humans
• Male
• Meningitis, Bacterial (etiology)
• Middle Aged
• Neuroleptic Malignant Syndrome (etiology)
• Pneumonia, Bacterial (etiology)
• Psychotic Disorders (drug therapy)