Clozapine-associated pneumonia and respiratory arrest secondary to severe constipation.

Abstract

Clozapine is often the drug of choice within patients suffering from treatment-resistant paranoid schizophrenia. It has a complex side effects profile which includes potentially fatal agranulocytosis. Clozapine has also become increasingly associated with a range of other side effects including constipation and pneumonia. We report on a case of clozapine-induced severe constipation leading to a silent presentation of pneumonia with a subsequent respiratory arrest. To our knowledge, this is the first case report of pneumonia secondary to severe constipation occurring in the absence of respiratory aspiration of feculent vomitus. We suggest a new pathological mechanism by way of severe constipation leading to diaphragmatic dysfunction and subsequent clozapine-induced pneumonia. In addition, implications for clinical practice are outlined.

• Authors: Nuwan Galappathie, Sobia Khan
• Journal: Medicine, science, and the law (Med Sci Law) Vol. 54 Issue 2 Pg. 105-9 (Apr 2014) ISSN: 0025-8024 [Print] England
• PMID: 24052002 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antipsychotic Agents
• Clozapine

Topics

• Adult
• Antipsychotic Agents (adverse effects)
• Clozapine (adverse effects)
• Constipation (chemically induced, complications)
• Fecal Impaction (complications)
• Humans
• Male
• Pneumonia (etiology)
• Respiratory Insufficiency (etiology)
• Schizophrenia, Paranoid (drug therapy)
• Sigmoidoscopy