Successful Management of Acute Anti psychotic Poisoning Induced Multi-Organs Toxicities -A Case Report and Review of Literature

Abstract

Introduction: Atypical antipsychotics were usually used in management of many psychiatric disorders. Moreover, suicidal attempts by antipsychotic agents are not rare in clinical practice. Therefore toxicologists should be aware of the early detection and management of those patients. Clozapine is one of the most commonly used antipsychotic drugs due to its well-known efficacy.Case presentation: this is a case report of a young previously healthy male patient who committed suicide by ingestion of 1000 mg of the atypical antipsychotic drug clozapine. The case highlights the development of severe disturbed level of consciousness, extrapyramidal adverse effects, prolonged QTc with positive troponin, hypokalemia, hyperglycemia, transient hypertension, and elevated liver transaminases. Discussion: The proper treatment initiation of acute antipsychotic poisoning should be based on the patient's clinical assessment. Early central nervous system and cardiovascular support are the core treatment element. However, the case reported uncommon electrolyte and hepatic disturbances which require early detection and monitoring.Conclusion: Atypical antipsychotics are not usually a safe treatment option for psychiatric diseases. Acute clozapine poisoning is a serious condition in which early resuscitation is essential for good prognosis. Serious cardiac and metabolic adverse effects should be considered, early investigated and properly monitored. Serum drug level might not be helpful prognostic indicator for acute antipsychotic poisoning.

Keywords

• atypical antipsychotics
• clozapine
• clozapine level
• successful management