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Low-dose Clozapine-induced Seizure: A Case Report
Abdullah Bolu1, Süleyman Akarsu2, Erdal Pan1
1Aircrew's Health Research and Training Center, Eskişehir, Turkey.
Summary
This case report highlights a patient experiencing tonic-clonic seizures from a low dose of clozapine, despite no prior seizure risk. Regular EEG monitoring and clozapine plasma level checks may help prevent seizures.
Area of Science:
- Neuroscience
- Pharmacology
- Clinical Psychiatry
Background:
- Clozapine is an atypical antipsychotic used for treatment-resistant schizophrenia.
- Seizures are a known, dose-dependent adverse effect of clozapine therapy.
- Identifying seizure risk factors and management strategies is crucial for patient safety.
Observation:
- A 29-year-old male with schizophrenia experienced a tonic-clonic seizure while on a low daily dose of clozapine (200 mg).
- The patient had no pre-existing seizure risk factors.
- Electroencephalography (EEG) revealed bilateral diffuse epileptic activity.
Findings:
- This case is notable as seizures occurred at a low clozapine dosage (200 mg/day), challenging the typical dose-dependent seizure risk profile.
- The occurrence of seizures in a patient without prior risk factors underscores the unpredictable nature of clozapine's side effects.
Implications:
- Low-dose clozapine can precipitate seizures even in individuals without apparent seizure predisposition.
- Regular EEG monitoring and therapeutic drug monitoring of clozapine plasma levels are recommended to mitigate seizure risk.
- This case emphasizes the need for vigilant patient monitoring during clozapine treatment, irrespective of dosage or perceived risk.
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