Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-24T20:59:48.805Z Has data issue: false hasContentIssue false

Case 19: - The gentleman with sudden onset of akathisia on clozapine (Clozaril)

Published online by Cambridge University Press:  03 April 2024

By
Nevena Radonjić
Edited by
Nevena V. Radonjić ,
Thomas L. Schwartz  and
Stephen M. Stahl
Nevena V. Radonjić
Affiliation:
State University of New York Upstate Medical University
Thomas L. Schwartz
Affiliation:
State University of New York Upstate Medical University
Stephen M. Stahl
Affiliation:
University of California, San Diego
Get access

Summary

What is the main metabolic pathway in the metabolism of clozapine (Clozaril)?

Keywords

akathisiaCOVID-19cytokinesanticholinergicsclozapine (Clozaril)benztropine (Cogentin)hydroxyzine (Vistaril)paliperidone (Invega)
Type
Chapter
Information
Case Studies: Stahl's Essential Psychopharmacology , pp. 327 - 344
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barnes, TRE. A rating scale for drug-induced akathisia. Br J Psychiatry 1989; 154:672–6CrossRefGoogle ScholarPubMed
Bayraktar, I˙, Yalçın, N, Demirkan, K. The potential interaction between COVID-19 vaccines and clozapine: a novel approach for clinical trials. Int J Clin Pract 2021; 75(8):e14441CrossRefGoogle ScholarPubMed
Cranshaw, T, Harikumar, T. COVID-19 infection may cause clozapine intoxication: case report and discussion. Schizophr Bull 2020; 46:751CrossRefGoogle Scholar
Edinoff, AN, Fort, JM, Woo, JJ, et al. Selective serotonin reuptake inhibitors and clozapine: clinically relevant interactions and considerations. Neurol Int 2021; 13:445–63CrossRefGoogle ScholarPubMed
Gerlach, J, Lublin, H, Peacock, L. Extrapyramidal symptoms during long-term treatment with antipsychotics: special focus on clozapine and D1 and D2 dopamine antagonists. Neuropsychopharmacology 1996; 14 Suppl.:35S–39SCrossRefGoogle ScholarPubMed
Jeong, SH, Kim, YS. Challenges in prescribing clozapine in the era of COVID-19: a review focused on immunological implications. Clin Psychopharmacol Neurosci 2021; 19:411–22CrossRefGoogle ScholarPubMed
Loonen, AJM, Stahl, SM. The mechanism of drug-induced akathisia. CNS Spectrums 2011; 16:7–10CrossRefGoogle Scholar
Marder, SR, Essock, SM, Miller, AL, et al. Physical health monitoring of patients with schizophrenia. Am J Psychiatry 2004; 161:1334–49CrossRefGoogle ScholarPubMed
Masuda, T, Misawa, F, Takase, M, et al. Association with hospitalization and all-cause discontinuation among patients with schizophrenia on clozapine vs other oral second-generation antipsychotics: a systematic review and meta-analysis of cohort studies. JAMA Psychiatry 2019; 76:1052–62CrossRefGoogle ScholarPubMed
Meyer, JM, Stahl, SM. Binding Profile, Metabolism, Kinetics, Drug Interactions and Use of Plasma Levels. Cambridge: Cambridge University Press, 2019, 90–113Google Scholar
Poyurovsky, M. Acute antipsychotic-induced akathisia revisited. Br J Psychiatry 2010; 196:89–91CrossRefGoogle ScholarPubMed
Poyurovsky, M, Weizman, A. Treatment of antipsychotic-induced akathisia: role of serotonin 5-HT2a receptor antagonists. Drugs 2020; 80:871–82CrossRefGoogle Scholar
Pringsheim, T, Gardner, D, Addington, D, et al. The assessment and treatment of antipsychotic-induced akathisia. Can J Psychiatry 2018; 63:719–29Google ScholarPubMed
Roiter, B, Pigato, G, Antonini, A. Prevalence of extrapyramidal symptoms in in-patients with severe mental illnesses: focus on Parkinsonism. Front Neurol 2020; 11:593143CrossRefGoogle ScholarPubMed
Stahl, SM. Targeting Dopamine and Serotonin Receptors for Psychosis, Mood, and Beyond: So-Called “Antipsychotics,” 5. Cambridge: Cambridge University Press, 2021.Google Scholar
Tio, N, Schulte, PFJ, Martens, HJM. Clozapine intoxication in COVID-19. Am J Psychiatry 2021; 178:123–7CrossRefGoogle ScholarPubMed
Vermeulen, JM, van Rooijen, G, van de Kerkhof, MPJ, et al. Clozapine and long-term mortality risk in patients with schizophrenia: a systematic review and meta-analysis of studies lasting 1.1–12.5 years. Schizophr Bull 2019; 45:315–29CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×