title: [Peri-orbital oedema and therapy-resistant hypertension: unusual side-effects of clozapine].
abstract: A 49-year-old male, known to have been suffering from paranoid schizophrenia for 10 years, was treated twice with clozapine. Although the clozapine alleviated his psychosis, the patient developed peri-orbital oedema repeatedly. As a result he requested a switch to a different antipsychotic. Also, while the patient was on clozapine, it proved difficult to regulate his hypertension. A possible explanation for these two side-effects is that clozapine blocks the renal dopamine D4 receptor, preventing it from performing its normal natriuretic and diuretic function. In view of the high but largely unnoticed incidence of hypertension in patients on clozapine (4%), we advise that such patients should receive structured somatic screening in a clinical setting.
authors.affiliation: Lange Nieuwstraat 119, 3512 PG, Utrecht. an.visscher@altrecht.nl
authors.forename: A J E
authors.initials: AJ
authors.lastname: Visscher
authors.forename: D
authors.initials: D
authors.lastname: Cohen
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003024:Clozapine / Q000009:adverse effects* / Q000627:therapeutic use; D004487:Edema / Q000139:chemically induced*; D006801:Humans; D006973:Hypertension / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000139:chemically induced*; D012563:Schizophrenia, Paranoid / Q000188:drug therapy
chemical_list: D014150:Antipsychotic Agents; D003024:Clozapine