Hepatoxicity induced by clozapine: Case report and brief review

Revista Colombiana de psiquiatria (English ed.) Pub Date : 2023-04-01 DOI:10.1016/j.rcpeng.2021.04.005

Joshep Revilla-Zúñiga , Joise Cornejo-Del Carpio , Lizardo Cruzado

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Abstract

Introduction

Antipsychotics are drugs that can produce transient elevations of hepatic enzymes. Clozapine is an atypical antipsychotic used in treatment-resistant schizophrenia and there is evidence that it can produce elevations of hepatic transaminases, expression of liver damage in a hepatocellular pattern.

Methods

Case report and non-systematic review of the relevant literature.

Case presentation

A 39-year-old woman with a diagnosis of paranoid schizophrenia attended the emergency department of a general hospital for nausea, vomiting and jaundice that appeared after the initiation of clozapine. There was no clinical improvement during hospitalisation, and death occurred after 44 days.

Literature review

Clozapine can increase the liver enzyme levels transiently and asymptomatically; however, there are clinical criteria that recommend the withdrawal of the antipsychotic.

Conclusions

This is the third case reported in the literature of a fatal outcome of clozapine-induced hepatotoxicity.

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氯氮平致肝毒性:病例报告及简要回顾

引言抗精神病药物是一种能产生肝酶瞬时升高的药物。氯氮平是一种非典型的抗精神病药物，用于治疗难治性精神分裂症，有证据表明它可以引起肝转氨酶升高，即肝细胞模式中肝损伤的表达。方法采用病例报告和非系统查阅相关文献的方法。病例介绍：一名39岁的女性被诊断为偏执性精神分裂症，因服用氯氮平后出现恶心、呕吐和黄疸而到综合医院急诊科就诊。住院期间没有任何临床改善，44天后死亡。文献综述氯氮平能瞬时无症状地提高肝酶水平；然而，有临床标准建议停用抗精神病药物。结论这是文献中报道的第三例氯氮平肝毒性致死的病例。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Revista Colombiana de psiquiatria (English ed.)

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