A case of necrotizing enterocolitis in a 19-year old man treated for schizophrenic
disorder, induced by a drug association involving clozapine and requiring surgical
treatment, is presented. To our knowledge only few reports have described the occurrence
of this complication with atypical antipsychotics. Evidence for linking this complication
to clozapine was reinforced by the absence of any viral or bacterial infection. The
authors present a review of similar cases, stress the potential hazards induced by
such drug combinations and discuss supposed mechanisms of this enterocolitis.
References
- 1 American Psychiatric A ssociation. Diagnostic and Statistical Manual of Mental Disorders
(4th ed.) Washington, DC; American Psychiatric Association 1994
- 2
Ausseur A, Leroy B, Bazin B, Sarraz-Bournet B, Oureib J, Georges H.
Acute necrotizing enterocolitis during a prolonged treatment with neuroleptics.
Presse Med.
1995;
2
571-574
- 3
Benamouzig R, Chaussade S, Roche H, Aubert A, Fiessenger J -N, Carlet J, Dazza F -E,
Couturier D.
Rhabdomyolyse aiguë et entérocolite nécrosante survenues après la prise de fénovérine.
Gastroentérol Clin Biol.
1992;
16
719-720
- 4
Conca A, Beraus W, Konig P, Waschgler R.
A case of pharmacokinetic interference in comedication of clozapine and valproic acid.
Pharmacopsychiatry.
2000;
33
234-235
- 5
Freudenreich O, Goff D C.
Colon perforation and peritonitis associated with clozapine.
J Clin Psychiatry.
2000;
61
950-951
- 6
Gollock J M, Thomson J P.
Ischaemic colitis associated with psychotropic drugs.
Postgrad Med J .
1984;
60
564-565
- 7
Grohmann R, Ruther E, Sassim N, Schmidt L G.
Adverse effects of clozapine.
Psychopharmacology.
1989;
99
101-104
- 8
Haack M -J, Bak M L, Beurskens R, Maes M, Stolk L M, Delespaul P A.
Toxic rise of clozapine in relation to inflammation.
Eur Neuropsychopharmacol.
2003;
13
381-385
- 9
Hayes G, Gibler B.
Clozapine-induced constipation.
Am J Psychiatry.
1995;
152
298
- 10
Killian J G, Kerr K, Lawrence C, Celermajer D S.
Myocarditis and myopathy associated with clozapine.
Lancet.
1999;
27
1841-1845
- 11
Larrey D, Lainey E, Blanc P, Diaz D, David R, Biaggi A.
Acute colitis associated with prolonged administration of neuroleptics.
J Clin Gastroenterol.
1992;
14
64-67
- 12
Lu M K.
Clinical analysis in the main side effects of clozapine: enclosed 600 case reports.
Zhonghua Shen Jing Jing Shen Ke Za Zhi .
1991;
24
71-74
- 13
Meltzer H Y, Cola P A, Parsa M.
Marked elevation of serum creatine kinase activity associated with antipsychotic drug
treatment.
Neuropsychopharmacology.
1996;
15
395-405
- 14
Pollmacher T, Schuld A, Kraus T, Haack M, Hinze-Selch D.
Zur klinischen Relevanz der Wirkung von Clozapin auf die Freisetzung von Zytokinen
und löslichen Zytokinrezeptoren.
Fortschr Neurol Psychiatr.
2001;
69
65-74
- 15
Scelsa S N, Simpson D M, McQuistion H L, Fineman A, Ault K, Reichler B.
Clozapine-induced myotoxicity in patients with chronic psychotic disorders.
Neurology.
1996;
47
1518-1523
- 16
Schwartz B J, Frisolone J A.
A case report of clozapine-induced gastric outlet obstruction.
Am J Psychiatry.
1993;
150
1563
- 17
Shammi C M, Remington G.
Clozapine-induced necrotizing colitis.
J Clin Psychopharmacology.
1997;
17
230-231
- 18
Tang W K, Ungvari G S.
Clozapine-induced intestinal obdtruction.
ANZ J Med.
1999;
29
560
- 19
Theret L, Germain M L, Burde A.
Actualité de l'utilisation de la clozapine à l’Hôpital psychiatrique de Chalons-sur-Marne:
occlusions intestinales sous clozapine.
Ann Médico-Psychologiques.
1995;
153
474-477
Dr. Raphaël Gourevitch
Service Hospitalo Universitaire
Sainte-Anne Hospital
7 Rue Cabanis
75014 Paris
France
Phone: +33 1 4438 5270
Fax: +33 1 4438 5279
Email: r.gourevitch@ch-sainte-anne.fr