title: Phenytoin intoxication in a clozapine-related prolonged seizure.
abstract: Phenytoin is a first-line drug for the treatment of status epilepticus. We report a case of phenytoin intoxication after intravenous phenytoin loading in a patient with clozapine-related seizures. To our knowledge, this is the first description of phenytoin intoxication due to CYP2C9 inhibition by clozapine. This case report is important because it supports the use of a lower intravenous loading dose of phenytoin in patients with clozapine-related status epilepticus.
authors.affiliation: Department of Neurology, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Revital
authors.initials: R
authors.lastname: Gandelman-Marton
authors.forename: Jacques
authors.initials: J
authors.lastname: Theitler
authors.forename: Colin
authors.initials: C
authors.lastname: Klein
authors.forename: Jose Martin
authors.initials: JM
authors.lastname: Rabey
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003024:Clozapine / Q000009:adverse effects* / Q000627:therapeutic use; D004347:Drug Interactions; D005260:Female; D006801:Humans; D010672:Phenytoin / Q000009:adverse effects* / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy*; D012640:Seizures / Q000139:chemically induced* / Q000188:drug therapy*
chemical_list: D000927:Anticonvulsants; D014150:Antipsychotic Agents; D010672:Phenytoin; D003024:Clozapine