RT Journal Article
SR Electronic
T1 Clozapine toxicity: a cautionary palliative care tale
JF BMJ Supportive & Palliative Care
JO BMJ Support Palliat Care
FD British Medical Journal Publishing Group
SP 312
OP 313
DO 10.1136/bmjspcare-2019-001988
VO 10
IS 3
A1 Michael Macfarlane
A1 Julita Shahab
A1 Derek Willis
YR 2020
UL http://spcare.bmj.com/content/10/3/312.abstract
AB Objective This case report presents an unusual case of clozapine toxicity secondary to reduced smoking habit mimicking a patient approaching end of life.Methods It is a cautionary tale for palliative care specialists, perhaps unaware of the effect of cigarette smoke on metabolism of this antipsychotic, to be aware of.Results Following specialist advice and change of antipsychotic medication, this patient’s condition improved to the point that he was discharged from the hospice.Conclusion Palliative care specialists should be aware that reducing cigarette consumption can alter metabolism of clozapine, potentially causing drug accumulation and toxicity with features which mimic deterioration towards end of life. Specialist advice should be sought in such a situation.