Minimal dose for severe poisoning and influencing factors in acute human clozapine intoxication: A 13-year retrospective study

Clinical Neuropharmacology

Volumn 33, Issue 5, 2010, Pages 230-234

  Krämer, Isabel ^a,b   Rauber Lüthy, Christine ^a   Kupferschmidt, Hugo ^a   Krähenbühl, Stephan ^b   Ceschi, Alessandro ^a  

^a Schweizerisches Toxikologisches Informationszentrum   (Switzerland)

^b UNIVERSITY HOSPITAL BASEL   (Switzerland)

Author keywords

atypical antipsychotic drugs; decontamination; overdose; poisoning; pretreatment

Indexed keywords

CLOZAPINE;

ADULT; AGED; AGITATION; ARTICLE; BRADYKINESIA; CENTRAL NERVOUS SYSTEM DEPRESSION; CONFUSION; CONTROLLED STUDY; CORRELATION ANALYSIS; DEPRESSION; DISEASE SEVERITY; DISORIENTATION; DRUG INTOXICATION; DYSARTHRIA; FEMALE; HUMAN; HYPERTENSION; MAJOR CLINICAL STUDY; MALE; PRIORITY JOURNAL; QT PROLONGATION; RESPIRATION DEPRESSION; RESTLESSNESS; RETROSPECTIVE STUDY; RISK ASSESSMENT; RISK FACTOR; SCHIZOPHRENIA; SIDE EFFECT; STATISTICAL SIGNIFICANCE; SYMPTOM; TACHYCARDIA;

ADULT; AGED; AGED, 80 AND OVER; ANTIDOTES; ANTIPSYCHOTIC AGENTS; CHARCOAL; CLOZAPINE; DOSE-RESPONSE RELATIONSHIP, DRUG; FEMALE; GASTRIC LAVAGE; GLASGOW COMA SCALE; HUMANS; MALE; MIDDLE AGED; POISONING; RETROSPECTIVE STUDIES; YOUNG ADULT;

EID: 77958019525     PISSN: 03625664     EISSN: None     Source Type: Journal    
DOI: 10.1097/WNF.0b013e3181f0ec55     Document Type: Article

References (26)

1. Daskalakis ZJ, George TP. Clozapine, GABA(B), and the treatment of resistant schizophrenia. Clin Pharmacol Ther 2009;86:442Y446.
2. Thomas AA, Friedman JH. Current use of clozapine in Parkinson disease and related disorders. Clin Neuropharmacol 2010;33:14Y16.
3. Beelen AP, Yeo KT, Lewis LD. Asymptomatic QTc prolongation associated with quetiapine fumarate overdose in a patient being treated with risperidone. Hum Exp Toxicol 2001;20:215Y219.
4. Burns MJ. The pharmacology and toxicology of atypical antipsychotic agents. J Toxicol Clin Toxicol 2001;39:1Y14.
5. Richelson E. Receptor pharmacology of neuroleptics: relation to clinical effects. J Clin Psychiatry 1999;60(suppl 10):5Y14.
6. Richelson E, Nelson A. Antagonism by neuroleptics of neurotransmitter receptors of normal human brain in vitro. Eur J Pharmacol 1984;103:197Y204. (Pubitemid 14028974)
7. Gray L, Van den Buuse M, Scarr E, et al. Clozapine reverses schizophrenia-related behaviours in the metabotropic glutamate receptor 5 knockout mouse: association with N-methyl-D-aspartic acid receptor upregulation. Int J Neuropsychopharmacol 2009;12:45Y60.
8. Piccini G, Ceroni P, Marchesi C, et al. Acute clozapine overdosage. Br J Psychiatry 1997;170:290.
9. Reith D, Monteleone JP, Whyte IM, et al. Features and toxicokinetics of clozapine in overdose. Ther Drug Monit 1998;20:92Y97.
10. Welber MR, Nevins S. Clozapine overdose, a case report. J Emerg Med 1995;13:199Y202.
11. Meeker JE, Herrmann PW, Som CW, et al. Clozapine tissue concentrations following an apparent suicidal overdose of Clorazil. J Anal Toxicol 1992;16:54Y56.
12. Sartorius A, Hewer W, Zink M, et al. High-dose clozapine intoxication. J Clin Psychopharmacol 2002;22:91Y92.
13. Pollak PT, Shafer SL. Teaching application of clinical pharmacology skills using unusual observations from clozapine overdoses. J Clin Pharmacol 2004;44:141Y149.
14. Hägg S, Spigset O, Edwardsson H, et al. Prolonged sedation and slowly decreasing clozapine serum concentrations after an overdose. J Clin Psychopharmacol 1999;19:282Y284.
15. Guirguis M, Gossweiler B, Kupferschmidt H, et al. TOXIVa multifunctional system for poisons information and clinical toxicological data evaluation. J Toxicol Clin Toxicol 1999;37:405.
16. Liechti ME, Kupferschmidt H. Gamma-hydroxybutyrate (GHB) and gamma-butyrolactone (GBL): analysis of overdose cases reported to the Swiss Toxicological Information Centre. Swiss Med Wkly 2004;134:534Y537.
17. Persson HE, Sjöbeerg GK, Haines JA. Poisoning severity score. Grading of acute poisoning. J Toxicol Clin Toxicol 1998;36:205Y213.
18. Baca-Garcia E, Perez-Rodriguez MM, Mann JJ, et al. Suicidal behavior in young women. Psychiatr Clin North Am 2008;31:317Y331.
19. Buckley NA, Dawson AH, Whyte IM, et al. An analysis of age and gender influences on the relative risk for suicide and psychotropic drug self-poisoning. Acta Psychiatr Scand 1996;93:168Y171.
20. Crumb WJ Jr, Ekins S, Sarazan RD, et al. Effects of antipsychotic drugs on I (to), I (Na), I (sus), I (K1), and hERG: QT prolongation, structure activity relationship, and network analysis. Pharm Res 2006;23:1133Y1143.
21. Meltzer HY. What's atypical about atypical antipsychotic drugs? Curr Opin Pharmacol 2004;4:53Y57.
22. Bischoff S, Christen P, Vassout A. Blockade of hippocampal dopamine (DA) receptors: a tool for antipsychotics with low extrapyramidal side effects. Prog Neuropsychopharmacol Biol Psychiatry 1988;12:455Y467.
23. Trenton A, Currier G, Zwemer F. Fatalities associated with therapeutic use and overdose of atypical antipsychotics. CNS Drugs 2003;17:307Y324.
24. Mady S, Wax P, Wang D, et al. Pediatric clozapine intoxication. Am J Emerg Med 1996;14:462Y463.
25. Miodownik C, Lerner V, Kibari A, et al. The effect of sudden clozapine discontinuation on management of schizophrenic patients: a retrospective controlled study. J Clin Psychiatry 2006;67:1204Y1208.
26. Chyka PA, Seger D, Krenzelok EP, et al. Position paper: single-dose activated charcoal. Clin Toxicol (Phila) 2005;43:61Y87.