Abstract
A 25-year-old woman, known to have schizoaffective disorder, presented with symptoms that had arisen a few weeks earlier. The symptoms indicated that she had a toxic clozapine blood level. The probable cause of the toxicity was a pharmacokinetic interaction between citalopram and clozapine at the level of the cytochrome P450 system. A literature search reveals the importance of monitoring the interactions between selective serotonin reuptake inhibitors and clozapine, a procedure which should, if possible, be accompanied by blood level measurements. Caution is called for, particularly when non-smokers are involved.
Publication types
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Case Reports
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English Abstract
MeSH terms
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Adult
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Antipsychotic Agents / adverse effects
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Antipsychotic Agents / blood
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Antipsychotic Agents / pharmacokinetics
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Clozapine / adverse effects
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Clozapine / blood
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Clozapine / pharmacokinetics*
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Cytochrome P-450 Enzyme Inhibitors*
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Drug Interactions
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Enzyme Inhibitors / adverse effects
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Enzyme Inhibitors / blood
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Enzyme Inhibitors / pharmacokinetics*
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Female
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Humans
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Psychotic Disorders / drug therapy*
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Selective Serotonin Reuptake Inhibitors / adverse effects
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Selective Serotonin Reuptake Inhibitors / blood
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Selective Serotonin Reuptake Inhibitors / pharmacokinetics*
Substances
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Antipsychotic Agents
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Cytochrome P-450 Enzyme Inhibitors
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Enzyme Inhibitors
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Serotonin Uptake Inhibitors
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Clozapine