Thapaliya, Suresh, Whiskey, Eromona, Firdosi, Mudasir (2024) Effective and safe use of intramuscular clozapine in a patient presenting with catatonia and thrombocytopenia. BMJ Case Reports, 17 (8). Article Number e260197. ISSN 1757-790X. (doi:10.1136/bcr-2024-260197) (KAR id:106900)
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Official URL: https://doi.org/10.1136/bcr-2024-260197 |
Abstract
Clozapine is the most effective medication for the management of treatment-resistant schizophrenia and schizoaffective disorder, and its discontinuation can pose significant challenges in treatment. We present a patient with a diagnosis of schizoaffective disorder who was stable on clozapine for a decade until discontinuation due to thrombocytopenia. She experienced a relapse of her illness, presenting with psychotic and catatonic features with poor oral intake and physical health complications requiring a lengthy admission to the hospital. There was a poor response to alternative antipsychotics and a full course of electroconvulsive therapy. Intramuscular (IM) clozapine was initiated due to catatonia and refusal to accept oral medications. After receiving 10 doses of IM clozapine, she started accepting oral clozapine and made a full recovery within a few weeks. The low platelet count was persistent, and a bone marrow biopsy showed results consistent with immune thrombocytopenia being the cause of that low platelet count.
Item Type: | Article |
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DOI/Identification number: | 10.1136/bcr-2024-260197 |
Uncontrolled keywords: | Thrombocytopenia - chemically induced - drug therapy, Treatment Outcome, Clozapine - adverse effects - administration & dosage - therapeutic use, Catatonia - drug therapy, Female, Injections, Intramuscular, Antipsychotic Agents - administration & dosage - adverse effects - therapeutic use, Psychotic Disorders - drug therapy, Haematology (drugs and medicines), Ethics, Immunology, Psychiatry (drugs and medicines), Haematology (incl blood transfusion), Middle Aged, Humans |
Subjects: | R Medicine |
Divisions: | Divisions > Division of Natural Sciences > Kent and Medway Medical School |
Funders: | University of Kent (https://ror.org/00xkeyj56) |
Depositing User: | Manfred Gschwandtner |
Date Deposited: | 15 Aug 2024 11:23 UTC |
Last Modified: | 05 Nov 2024 13:12 UTC |
Resource URI: | https://kar.kent.ac.uk/id/eprint/106900 (The current URI for this page, for reference purposes) |
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