ArticlePCN reports : psychiatry and clinical neurosciences2022
Successful rechallenge with clozapine after discontinuation due to drug-induced pneumonia: A case report.
Article in PCN reports : psychiatry and clinical neurosciences, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed.
- Review
- Diagnostic algorithm for clozapine-induced myocarditis: A systematic review.World journal of psychiatry · 2025Article
- Patterns of C-reactive protein trends during clozapine titration and the onset of clozapine-induced inflammation: a case series of weekly and daily C-reactive protein monitoring.Frontiers in psychiatry · 2024Article
- Slower clozapine titration is associated with delayed onset of clozapine-induced fever among Japanese patients with schizophrenia.Schizophrenia (Heidelberg, Germany) · 2023Article
- Japanese patients need slower, personalized clozapine titrations: A comment on the case described by Kikuchi et al.PCN reports : psychiatry and clinical neurosciences · 2023Article
- Reflections on the Lack of Consideration of Ethnic Ancestry to Stratify Clozapine Dosing.Psychiatry investigation · 2023Article
- Successful rechallenge with clozapine after discontinuation due to drug-induced pneumonia: A case report.PCN reports : psychiatry and clinical neurosciences · 2022Article
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5 authors.
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Abstract
Background: There have been a limited number of case reports of clozapine-induced pneumonia. Few have reported rechallenging of clozapine after discontinuation due to the side-effect. Case Presentation: A 43-year-old man was diagnosed with schizophrenia after developing auditory hallucinations and delusions of persecution and reference. After diagnosing him with treatment-resistant schizophrenia, clozapine was started. From a starting dose of 12.5 mg/day, we increased it by 25 mg every 2-3 days to reach 150 mg/day by Day 15. On Day 17, his body temperature suddenly rose to 39.6°C (103.3°F) without any other apparent physical symptoms. Blood biochemistry testing showed elevated C-reactive protein (CRP) and high counts of leukocytes and neutrophils, but not eosinophils. Chest computed tomography revealed ground-glass opacities in the lower lobes of both lungs. Suspecting bacterial pneumonia, we started him on levofloxacin 500 mg/day. However, pneumonia exacerbated, and eosinophilia became apparent 5 days after the onset of fever. We suspected acute eosinophilic pneumonia induced by clozapine and discontinued its administration the same day. The patient clinically recovered the next day after stopping clozapine. After stopping clozapine, his psychiatric symptoms, such as persecutory/referential delusions, irritability, and polydipsia, became worse. We decided to rechallenge with clozapine in incremental doses slower than the standard protocol, along with careful monitoring of CRP and eosinophil counts. Pneumonia has not recurred, and his psychiatric symptoms have been well managed. Conclusion: Our experience suggests that some patients with inflammatory reactions to clozapine can still take the drug if it is reintroduced with caution.
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