Accidental clozapine intoxication in a ten-year-old child

Clozapine is a tricyclic dibenzodiazepine derivative used commonly in the treatment of schizophrenia. Severe side effects of overdose have been described in children. This report describes the unintentional ingestion of clozapine by a 10-y-o girl, presenting dramatic changes of mental status and progressive alteration of consciousness with a Glasgow Coma Scale drop from 12 to 7. Urine analysis revealed 500 microg clozapine/L 24 h after ingestion. Full resolution of symptoms occurred after approximately 55 h with no sequels or alterations at follow-up. Awareness must be taken when administering atypical antipsychotics such as clozapine to children because of the severe intoxication effects cases reported.