[Underexposed, potential lethal gastrointestinal adverse events associated with clozapine use]

Clozapine is an effective antipsychotic with antidopaminergic, anticholinergic and antiserotonergic effects. Due to potential adverse events, agranulocytosis being the most feared, patients using clozapine need to be closely monitored. A lesser known but equally common and potential lethal adverse effect is clozapine-induced gastrointestinal hypomotility (CIGH), which can cause a paralytic ileus, gut mucosal ischemia or aspiration pneumonia. We saw a male patient, aged 61 years, who used clozapine and suffered from CIGH, leading to frequent episodes of paralytic ileus requiring GE surgery. The case underlines the importance of timely recognition and treatment of clozapine-induced gastrointestinal hypomotility.