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Severe Clozapine Poisoning Treated by Extracorporeal Blood Purification Therapy
Clozapine is a frequently used antipsychotic that, in case of overdose, can cause severe adverse side effects, such as hematological, cardiovascular, and neurological complications. As there is no specific antidote or reversal agent available, extracorporeal techniques such as CytoSorb hemoadsorptio...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601855/ https://www.ncbi.nlm.nih.gov/pubmed/37900923 http://dx.doi.org/10.1159/000531130 |
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author | Hartjes, Andreas Machnik, Matthäus Kubasta, Christa Schrattbauer, Karl |
author_facet | Hartjes, Andreas Machnik, Matthäus Kubasta, Christa Schrattbauer, Karl |
author_sort | Hartjes, Andreas |
collection | PubMed |
description | Clozapine is a frequently used antipsychotic that, in case of overdose, can cause severe adverse side effects, such as hematological, cardiovascular, and neurological complications. As there is no specific antidote or reversal agent available, extracorporeal techniques such as CytoSorb hemoadsorption might represent a viable option, having already been used in a variety of intoxication scenarios with favorable rates of success. A 56-year-old male was admitted with generalized epileptic seizures and arrhythmias following ingestion of clozapine in a suicide attempt (5,000 mg). Subsequently, conventional supportive care was initiated. To accelerate drug removal, continuous veno-venous hemodiafiltration including the application of CytoSorb hemoadsorption therapy was started. Serial measurements confirmed rapid reduction of clozapine plasma levels. The patient remained hemodynamically stable throughout this period. Furthermore, there were no cardiac arrhythmias detected and liver values were normal. The patient improved and was successfully extubated 3 days after admission with good vigilance and no residual neurological abnormalities. This is the first clinical case report on the use of CytoSorb hemoadsorption in severe clozapine intoxication which helped quickly and efficiently reduce clozapine levels to nontoxic serum levels while preserving organ function. Therefore, CytoSorb might represent an alternative treatment modality to be considered for potentially lethal clozapine intoxications. |
format | Online Article Text |
id | pubmed-10601855 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
spelling | pubmed-106018552023-10-27 Severe Clozapine Poisoning Treated by Extracorporeal Blood Purification Therapy Hartjes, Andreas Machnik, Matthäus Kubasta, Christa Schrattbauer, Karl Case Rep Nephrol Dial Single Case Clozapine is a frequently used antipsychotic that, in case of overdose, can cause severe adverse side effects, such as hematological, cardiovascular, and neurological complications. As there is no specific antidote or reversal agent available, extracorporeal techniques such as CytoSorb hemoadsorption might represent a viable option, having already been used in a variety of intoxication scenarios with favorable rates of success. A 56-year-old male was admitted with generalized epileptic seizures and arrhythmias following ingestion of clozapine in a suicide attempt (5,000 mg). Subsequently, conventional supportive care was initiated. To accelerate drug removal, continuous veno-venous hemodiafiltration including the application of CytoSorb hemoadsorption therapy was started. Serial measurements confirmed rapid reduction of clozapine plasma levels. The patient remained hemodynamically stable throughout this period. Furthermore, there were no cardiac arrhythmias detected and liver values were normal. The patient improved and was successfully extubated 3 days after admission with good vigilance and no residual neurological abnormalities. This is the first clinical case report on the use of CytoSorb hemoadsorption in severe clozapine intoxication which helped quickly and efficiently reduce clozapine levels to nontoxic serum levels while preserving organ function. Therefore, CytoSorb might represent an alternative treatment modality to be considered for potentially lethal clozapine intoxications. S. Karger AG 2023-07-27 /pmc/articles/PMC10601855/ /pubmed/37900923 http://dx.doi.org/10.1159/000531130 Text en © 2023 The Author(s). Published by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission. |
spellingShingle | Single Case Hartjes, Andreas Machnik, Matthäus Kubasta, Christa Schrattbauer, Karl Severe Clozapine Poisoning Treated by Extracorporeal Blood Purification Therapy |
title | Severe Clozapine Poisoning Treated by Extracorporeal Blood Purification Therapy |
title_full | Severe Clozapine Poisoning Treated by Extracorporeal Blood Purification Therapy |
title_fullStr | Severe Clozapine Poisoning Treated by Extracorporeal Blood Purification Therapy |
title_full_unstemmed | Severe Clozapine Poisoning Treated by Extracorporeal Blood Purification Therapy |
title_short | Severe Clozapine Poisoning Treated by Extracorporeal Blood Purification Therapy |
title_sort | severe clozapine poisoning treated by extracorporeal blood purification therapy |
topic | Single Case |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601855/ https://www.ncbi.nlm.nih.gov/pubmed/37900923 http://dx.doi.org/10.1159/000531130 |
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