[Clozapine and selective serotonin reuptake inhibitors: risks of toxicity].
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.
Michielsen
P J S
PJ
GGZ Westelijk Noord Brabant, Postbus 371,4600 AJ Bergen op Zoom. philip.michielsen@ggzwnb.nl
Thunnissen
M M
MM
Van Den Bossche
B
B
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D003024:Clozapine / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics*; D065607:Cytochrome P-450 Enzyme Inhibitors; D004347:Drug Interactions; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D011618:Psychotic Disorders / Q000188:drug therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics*
D014150:Antipsychotic Agents; D003024:Clozapine; D065607:Cytochrome P-450 Enzyme Inhibitors; D004791:Enzyme Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors