Clozapine is the preferred antipsychotic used for the treatment of resistant schizophrenia with suicidal ideation. The drug is started at a low dose and gradually increased to a target dose of 300-450 mg/day. It is well known to cause agranulocytosis and neutropenia. Several cases of fatal sepsis have been reported in neutropenic patients and emphasis is placed on monitoring for agranulocytosis; however, clozapine also causes intestinal hypomotility and constipation, which if unrecognized can lead to intestinal obstruction, bowel necrosis, and intra- abdominal sepsis. Reduced behavioral pain reactivity in schizophrenics may alter the ability to express pain, potentially leading to a delay in the presentation for medical attention. We report a case of fatal intra-abdominal sepsis secondary to an unrecognized case of clozapine-related constipation.
CITATION STYLE
Oke, V., Schmidt, F., Bhattarai, B., Basunia, M., Agu, C., Kaur, A., … Mungikar, P. (2015). Unrecognized clozapine-related constipation leading to fatal intra-abdominal sepsis - A case report. International Medical Case Reports Journal, 8, 189–192. https://doi.org/10.2147/IMCRJ.S86716
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