Effective and safe use of intramuscular clozapine in a patient presenting with catatonia and thrombocytopenia.
Journal article
Thapaliya, Suresh, Whiskey, Eromona and Firdosi, Mudasir 2024. Effective and safe use of intramuscular clozapine in a patient presenting with catatonia and thrombocytopenia. BMJ Case Reports. 17 (8), p. e260197. https://doi.org/10.1136/bcr-2024-260197
| Authors | Thapaliya, Suresh, Whiskey, Eromona and Firdosi, Mudasir |
|---|---|
| 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. [Abstract copyright: © BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.] |
| Keywords | Thrombocytopenia; Clozapine; Catatonia - drug therapy; Antipsychotic agents; Psychotic disorders; Immunology; Psychiatry ; Haematology |
| Year | 2024 |
| Journal | BMJ Case Reports |
| Journal citation | 17 (8), p. e260197 |
| Publisher | BMJ Publishing Group |
| ISSN | 1757-790X |
| Digital Object Identifier (DOI) | https://doi.org/10.1136/bcr-2024-260197 |
| https://doi.org/17/8/e260197 | |
| Official URL | https://casereports.bmj.com/content/17/8/e260197.long |
| Publication dates | |
| Online | 14 Aug 2024 |
| Publication process dates | |
| Accepted | 03 Aug 2024 |
| Deposited | 04 Sep 2024 |
| Accepted author manuscript | License File Access Level Open |
| Output status | Published |
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https://repository.canterbury.ac.uk/item/98xv8/effective-and-safe-use-of-intramuscular-clozapine-in-a-patient-presenting-with-catatonia-and-thrombocytopenia
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