A Case of Late-Onset Angioedema Associated With Clozapine and Redevelopment of Angioedema With Olanzapine

Tatar, Zeynep; Oflaz, Serap; Baran, Beata

doi:10.1097/jcp.0000000000000153

Cited by 11 publications

(13 citation statements)

References 13 publications

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“…5,9-15 Angioedema associated with drug use is usually IgE mediated and usually occurs in the first week of drug therapy. 9,16 As in our case, angioedema resolves within 24 to 48 hours after cessation of the drug and recurs if the same drug is given again. 16 The mechanism of the drug-related angioedema is believed to be a type I hypersensitivity reaction.…”

Section: Discussionsupporting

confidence: 52%

“…8 One study estimated the annual Lyme-associated cost to be approximately 25 million Euros in Germany. 9 Another study compared 52,795 individuals treated for Lyme disease with 263,975 matched controls and found that those with PTLD were associated with $3798 higher total health care costs and 66% more outpatient visits for a 12-month period; the annual cost in the United States was estimated to be more than $1 billion in 2015. 10 Prominent symptoms in patients with PTLD have included peripheral neuropathy, headaches, chronic fatigue, transient diffuse musculoskeletal pain and defects in cognition, memory, focus, and ability to multitask.…”

Section: Post-lyme Syndrome-associated Polyneuropathy Treatedmentioning

confidence: 99%

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Quetiapine Associated With Angioedema

Tuman

Şereflican

et al. 2016

Journal of Clinical Psychopharmacology

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Section: Discussionsupporting

confidence: 52%

Section: Post-lyme Syndrome-associated Polyneuropathy Treatedmentioning

confidence: 99%

Quetiapine Associated With Angioedema

Tuman

Şereflican

et al. 2016

Journal of Clinical Psychopharmacology

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“…hypersensitivity, which impose challenges in the management in these group of patients. There are reports on allergic asthmatic reactions (Stoppe et al 1992), allergic vasculitis (Penaskovic et al 2005), angioneurotic edema (Mishra et al 2007) and a case of lateonset angioedema (Tatar et al 2014) secondary to clozapine.…”

Section: Discussionmentioning

confidence: 99%

Allergic Cutaneous and Visceral Angioedema Secondary to Clozapine: A Case Report

Choy¹

2017

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ABSTRAK Laporan ini menerangkan kejadian tindak balas ubat clozapine yang jarang berlaku ABSTRACTThis report stresses on the occurrence of a rare adverse reaction to clozapine, i.e. allergic cutaneous and visceral angioedema, in a patient with treatment resistant schizophrenia (TRS). We report the case of a schizophrenic patient who was resistant to treatment and developed an allergic reaction involving her skin and gastro-intestinal system upon the commencement of clozapine. She was then treated with a combination pharmacotherapy which left some residual symptoms. The manifestation of allergic reactions to clozapine and its management strategies are discussed in the paper. There is a pressing need to develop a new psychotropic which is on par with clozapine.

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“…Angioedema is an event characterized by marked swelling of the subcutaneous or submucosal tissue and may affect various parts of the body, including the face, mouth, and extremities. This reaction is often mild and overall self-limiting but can be life-threatening, particularly in cases in which airway patency is threatened 1,2. Angioedema has been linked to a variety of medications and has specifically been associated with the use of several antipsychotic agents, including clozapine, olanzapine, iloperidone, haloperidol, quetiapine, paliperidone, ziprasidone, risperidone, and chlorpromazine 2-8…”

Section: Introductionmentioning

confidence: 99%

“…Limited prior case reports have identified angioedema cross-reactivity among antipsychotic medications. In one published case,2 a 27-year-old female taking clozapine for 5 years presented with facial swelling and periorbital eruption, prompting a diagnosis of acute angioedema. Clozapine therapy was discontinued, and upon resolution of angioedema, olanzapine was initiated; however, angioedema symptoms recurred within several days of initiation of olanzapine.…”

Section: Introductionmentioning

confidence: 99%

Cross-reaction of angioedema with clozapine, olanzapine, and quetiapine: A case report

Williams¹

2019

Mental Health Clinician

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Angioedema is characterized by marked swelling of the subcutaneous or submucosal tissue and may affect various parts of the body, including the face, mouth, and extremities. Angioedema has specifically been associated with the use of several antipsychotic agents, including clozapine, olanzapine, iloperidone, haloperidol, quetiapine, paliperidone, ziprasidone, risperidone, and chlorpromazine. A 67-year-old African American male with a past medical history significant for hypertension, coronary artery disease requiring stent placement, mitral insufficiency, hyperlipidemia, tobacco use disorder, and schizophrenia presented with altered mental status and disorientation in the setting of clozapine nonadherence, which prompted acute hospitalization for clozapine reinitiation. During clozapine titration, the patient developed edema, erythema, and pruritus on his face and arms along with lip swelling characteristic of angioedema. Upon discontinuation of clozapine, the patient was trialed on several other antipsychotic medications to help manage acute psychosis and subsequently developed angioedema symptoms with trials of both olanzapine and quetiapine. Following these 3 distinct events of angioedema, the clinical decision was made to no longer trial atypical antipsychotics for the patient, and loxapine was cautiously initiated. The patient responded well to loxapine and continued to tolerate loxapine therapy for years. This case report identifies angioedema cross-reaction linked with 3 second-generation antipsychotics. Given the potentially life-threatening nature of angioedema, awareness of recurrent angioedema should be undertaken when trialing antipsychotics following an episode of angioedema correlated to antipsychotic use, particularly when trialing antipsychotics from the same generation and with similar chemical structures.

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A Case of Late-Onset Angioedema Associated With Clozapine and Redevelopment of Angioedema With Olanzapine

Cited by 11 publications

References 13 publications

Quetiapine Associated With Angioedema

Quetiapine Associated With Angioedema

Allergic Cutaneous and Visceral Angioedema Secondary to Clozapine: A Case Report

Cross-reaction of angioedema with clozapine, olanzapine, and quetiapine: A case report

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