Document Type : Case Report
Authors
- Manal Abdelaziz Hassan 1
- Fatma Mohamed Magdy Badreldine 2
- Rasha Mohamed Abayazeed 3
- Rasha Ismail Abdelrasol Khedr 4
- Eman Mohamed Saleh 5
1 faculty of medicine Alexandria University
2 Departments of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Alexandria University, Champollion Street, El- Khartoum Square, Azarita Medical Campus, Alexandria, Egypt
3 Cardiology and angiology department, faculty of medicine, Alexandria University
4 Forensic medicine and clinical toxicology department, faculty of medicine, Alexandria University
5 Staff member at forensic medicine and clinical toxicology department faculty of medicine, Alexandria University
Abstract
Introduction: Atypical antipsychotics were usually used in management of many psychiatric disorders. Moreover, suicidal attempts by antipsychotic agents are not rare in clinical practice. Therefore toxicologists should be aware of the early detection and management of those patients. Clozapine is one of the most commonly used antipsychotic drugs due to its well-known efficacy.
Case presentation: this is a case report of a young previously healthy male patient who committed suicide by ingestion of 1000 mg of the atypical antipsychotic drug clozapine. The case highlights the development of severe disturbed level of consciousness, extrapyramidal adverse effects, prolonged QTc with positive troponin, hypokalemia, hyperglycemia, transient hypertension, and elevated liver transaminases. Discussion: The proper treatment initiation of acute antipsychotic poisoning should be based on the patient's clinical assessment. Early central nervous system and cardiovascular support are the core treatment element. However, the case reported uncommon electrolyte and hepatic disturbances which require early detection and monitoring.
Conclusion: Atypical antipsychotics are not usually a safe treatment option for psychiatric diseases. Acute clozapine poisoning is a serious condition in which early resuscitation is essential for good prognosis. Serious cardiac and metabolic adverse effects should be considered, early investigated and properly monitored. Serum drug level might not be helpful prognostic indicator for acute antipsychotic poisoning.
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Main Subjects
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