Published online Jul 16, 2021. doi: 10.12998/wjcc.v9.i20.5611
Peer-review started: February 8, 2021
First decision: March 27, 2021
Revised: April 7, 2021
Accepted: May 20, 2021
Article in press: May 20, 2021
Published online: July 16, 2021
Processing time: 148 Days and 16.6 Hours
Treatment-resistant schizophrenia is a severe form of schizophrenia characterized by poor response to at least two antipsychotic drugs and is typically treated with clozapine. However, clozapine lowers the epileptic threshold, leading to seizures, which are severe side effects of antipsychotics that result in multiple complications. Clozapine-related seizures are generally considered to be dose-dependent and especially rare in the low-dose (150-300 mg/d) clozapine treated population. Due to clinical rarity, little is known about its clinical characteristics and treatment.
A 62-year-old Chinese man with a 40-year history of treatment-resistant schizophrenia presented to the Emergency Department with symptoms of myoclonus, consciousness disturbance and vomiting after taking 125 mg clozapine. Upon admission, the patient had a suddenly generalized tonic-clonic seizure lasting for about half a minute with persistent disturbance of consciousness, fever, cough and bloody sputum, which was considered to be low-dose clozapine-related seizure. After antiepileptic and multiple anti-infection treatments, the patient was discharged without epileptic or psychotic symptoms.
Our aim is to highlight the early prevention and optimal treatment of clozapine-related seizure through case analysis and literature review.
Core Tip: Clozapine-related seizure is a serious adverse reactions of clozapine, which should be given more attention to its early prevention and optimal treatment. Clinical features, treatment options and factors that may contribute to the development of clozapine-related seizures were summarized through case analysis and literature review, and relevant cases published in the last 20 years were summarized and listed.