Response after Infection-Associated Rise in Clozapine Levels in Treatment-Resistant Schizoaffective Disorder
The clinical management of patients with treatment-resistant psychotic disorders is still challenging despite years of extensive research. If first-line antipsychotic treatment proves ineffective, clozapine is considered golden standard. Herein, we report on a patient with schizoaffective disorder t...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Psychiatry |
| Online Access: | http://dx.doi.org/10.1155/2018/3174368 |
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| author | Nina H. Grootendorst-van Mil Anna R. M. Huiskens Sieds Dieleman Tom K. Birkenhäger |
| author_facet | Nina H. Grootendorst-van Mil Anna R. M. Huiskens Sieds Dieleman Tom K. Birkenhäger |
| author_sort | Nina H. Grootendorst-van Mil |
| collection | DOAJ |
| description | The clinical management of patients with treatment-resistant psychotic disorders is still challenging despite years of extensive research. If first-line antipsychotic treatment proves ineffective, clozapine is considered golden standard. Herein, we report on a patient with schizoaffective disorder that initially showed no response to treatment with clozapine and ECT and therefore reached a therapeutic dead end. After an unintentional exposure to supratherapeutic clozapine levels, related to a pneumonia, a significant and persistent reduction of psychotic symptoms occurred. The report suggests a careful reevaluation of the clozapine dose in cases of treatment-resistant psychotic disorders with failed trials of clozapine. Further increase of dose may prove efficacious, although side effects should be closely monitored. Research to determine the upper threshold of clozapine for antipsychotic efficacy is warranted. |
| format | Article |
| id | doaj-art-4dda49f0902744a78de6008b49d240e0 |
| institution | Kabale University |
| issn | 2090-682X 2090-6838 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Psychiatry |
| spelling | doaj-art-4dda49f0902744a78de6008b49d240e02025-02-03T01:31:48ZengWileyCase Reports in Psychiatry2090-682X2090-68382018-01-01201810.1155/2018/31743683174368Response after Infection-Associated Rise in Clozapine Levels in Treatment-Resistant Schizoaffective DisorderNina H. Grootendorst-van Mil0Anna R. M. Huiskens1Sieds Dieleman2Tom K. Birkenhäger3Department of Psychiatry, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, NetherlandsDepartment of Psychiatry, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, NetherlandsDepartment of Psychiatry, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, NetherlandsDepartment of Psychiatry, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, NetherlandsThe clinical management of patients with treatment-resistant psychotic disorders is still challenging despite years of extensive research. If first-line antipsychotic treatment proves ineffective, clozapine is considered golden standard. Herein, we report on a patient with schizoaffective disorder that initially showed no response to treatment with clozapine and ECT and therefore reached a therapeutic dead end. After an unintentional exposure to supratherapeutic clozapine levels, related to a pneumonia, a significant and persistent reduction of psychotic symptoms occurred. The report suggests a careful reevaluation of the clozapine dose in cases of treatment-resistant psychotic disorders with failed trials of clozapine. Further increase of dose may prove efficacious, although side effects should be closely monitored. Research to determine the upper threshold of clozapine for antipsychotic efficacy is warranted.http://dx.doi.org/10.1155/2018/3174368 |
| spellingShingle | Nina H. Grootendorst-van Mil Anna R. M. Huiskens Sieds Dieleman Tom K. Birkenhäger Response after Infection-Associated Rise in Clozapine Levels in Treatment-Resistant Schizoaffective Disorder Case Reports in Psychiatry |
| title | Response after Infection-Associated Rise in Clozapine Levels in Treatment-Resistant Schizoaffective Disorder |
| title_full | Response after Infection-Associated Rise in Clozapine Levels in Treatment-Resistant Schizoaffective Disorder |
| title_fullStr | Response after Infection-Associated Rise in Clozapine Levels in Treatment-Resistant Schizoaffective Disorder |
| title_full_unstemmed | Response after Infection-Associated Rise in Clozapine Levels in Treatment-Resistant Schizoaffective Disorder |
| title_short | Response after Infection-Associated Rise in Clozapine Levels in Treatment-Resistant Schizoaffective Disorder |
| title_sort | response after infection associated rise in clozapine levels in treatment resistant schizoaffective disorder |
| url | http://dx.doi.org/10.1155/2018/3174368 |
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