PMID: 15242144Jul 10, 2004Paper

Management of marked liver enzyme increase during clozapine treatment: a case report and review of the literature

International Journal of Psychiatry in Medicine
Ayten ErdoganHakan Senturk

Abstract

Clozapine-induced hepatotoxicity is not infrequent and usually transient. It mostly causes asymptomatic elevation of liver transaminases. "Elevation in liver enzymes to what extent should preclude further treatment?" or "Is only a dose-reduction sufficient?" are questions yet to be answered. The present article uses a case report to discuss the treatment alternatives when liver enzymes reach three times the upper normal limits during the clozapine therapy. In the following case report, the authors describe a 27-year-old male patient diagnosed with schizophrenia, resistant to different atypical and typical antipsychotics. Based on the pathological findings of our patient and a review of the literature, the author summarizes the reasons for the liver enzymes increase and treatment alternatives during clozapine treatment. Substantial improvement was achieved with clozapine therapy. Increase in liver enzymes at the beginning of the clozapine treatment was successfully managed with a multidisciplinary approach: the treatment was initially withdrawn, afterwards restarted, and carefully continued. The authors demonstrate that clozapine may be cautiously continued in selected patients who showed marked psychiatric improvement with cloz...Continue Reading

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Citations

Dec 3, 2011·General Hospital Psychiatry·Karim SedkySteven Lippmann
Sep 2, 2008·Toxicology in Vitro : an International Journal Published in Association with BIBRA·Yanhua LuXiaoshu Bei
Feb 9, 2008·Progress in Neuro-psychopharmacology & Biological Psychiatry·Ayten ErdoganIbrahim Balcioglu
Jun 30, 2007·Progress in Neuro-psychopharmacology & Biological Psychiatry·Nuray AtasoyYucel Ustundag
Apr 25, 2006·Progress in Neuro-psychopharmacology & Biological Psychiatry·Tuba OzcanliAbdullah Sonsuz
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Jul 19, 2021·Schizophrenia Research·Cíntia Lopes DiasCristiano Noto

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