Severe Acidosis Followed by Withdrawal Delirium and Dystonia-like Movement afterClozapine Overdose

Clozapine過量導致嚴重酸中毒並產生戒斷後瞻望及肌張力不全

李姿誼(Tzu-I Lee) ； 李怡慧(I-Hui Lee) ； 吳安邦(An-Bang Wu) ； 楊延光(Yen-Kuang Yang)

《台灣精神醫學》 25卷4期 (2011/12) Pp. 279-282

https://doi.org/10.29478/TJP.201112.0007

並列摘要

Background: Due to receptor-binding complexity of clozapine, the symptoms of its overdose and withdrawal are complicated and vary greatly in different patients. Case Report: The case report describes a schizophrenic patient who took 5,000 mg clozapine in a suicidal attempt. He suffered from metabolic acidosis, generalized tonic and clonic seizures with respiratory failure. The patient regained clear consciousness after clozapine was withheld. Delirium, dystonia-like movement and rebound psychosis emerged on the 4th day. Clozapine withdrawal was the most likely the cause, and above-symptoms were improved gradually after clozapine was reloaded. Conclusion: We suggest that clozapine overdose may lead to lactic acidosis even without the complications of hypotension and respiratory failure. Several mechanisms are attributed to the various presentations of clozapine withdrawal. The manifestations in our patient underscored the risk of severe acidosis after clozapine overdose and the importance of prevention of clozapine withdrawal.

並列關鍵字

clozapine ； lactic acidosis ； intoxication ； withdrawal

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