Related Experiment Videos
Non-fatal clozapine (LEPONEX) intoxication with toxicokinetic evaluation
R Bedry1, L Deschamps, F Pehourcq
1Poison Centre, Pellegrin Hospital, Bordeaux, France.
Veterinary and Human Toxicology
|February 9, 1999
Summary
A man survived a massive clozapine overdose after a suicide attempt. High plasma clozapine levels were detected, with a prolonged elimination half-life, but he recovered fully.
Area of Science:
- Pharmacology
- Toxicology
- Emergency Medicine
Background:
- Clozapine is an atypical antipsychotic used to treat schizophrenia.
- Overdoses of clozapine can lead to severe toxicity, including seizures, coma, and cardiovascular complications.
- Co-ingestion of other substances, such as zopiclone and alcohol, can exacerbate clozapine toxicity.
Observation:
- A 29-year-old male ingested 3000 mg of clozapine, 150 mg of zopiclone, alprazolam, and alcohol in a suicide attempt.
- The patient presented with a deep hypotonic coma, respiratory depression, inhalation pneumonia, and vascular collapse.
- Intensive care management included mechanical ventilation, fluid resuscitation, and antibiotics.
Findings:
- High-performance liquid chromatography (HPLC) detected clozapine in plasma, with a 4-hour absorption phase and a peak serum concentration of 5200 ng/ml.
- Three distinct elimination half-life (t1/2) values were calculated: 38 hours, 24 hours, and 13 hours.
- The patient was discharged from the Intensive Care Unit after 72 hours with no sequelae.
Implications:
- This case highlights the potential for severe toxicity with massive clozapine overdose.
- The prolonged elimination half-life of clozapine in this case may be attributed to the high dose and co-ingestions.
- Prompt and intensive supportive care is crucial for managing clozapine overdose and improving patient outcomes.