Effect of Intravenous Lipid Emulsion on Clozapine Acute Toxicity in Rats

Yousefsani, Bahareh Sadat; Mohajeri, Seyed Ahmad; Moshiri, Mohammad; Jafarian, Amir Hossein; Hosseinzadeh, Hossein

doi:10.3831/kpi.2019.22.019

Cited by 7 publications

(6 citation statements)

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“…In the current study, assessment of GCS at 6 and 12 hours after admission revealed significantly faster regaining of consciousness in patients who administered SMOF Lipid compared to their controls. This coincides with Yousefsani et al 13 who demonstrated a significant response of clozapine-induced neurotoxicity in rats to IV infusion of 18.6 mg/kg ILE 20% 15 minutes after receiving a toxic dose of clozapine. Responses to lipid emulsion were presented as a significant termination of ataxia and a more rapid decrease in seizure scores.…”

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

“…8 Various case reports documented the recovery of acute antipsychotics toxicity in association with the administration of ILE. [9][10][11][12] Moreover, Yousefsani et al 13 have demonstrated the successful use of ILE for the treatment of acute clozapine-induced ataxia as well as seizures in rats. Nevertheless, there are no reported clinical trials on humans to recommend its therapeutic use.…”

Section: Introductionmentioning

confidence: 99%

“…Previous animal studies revealed the therapeutic role of ILE in restoring the mean arterial blood pressure and the wide QRS duration induced by combined amitriptyline and citalopram antidepressants in adult rats, 39 as well as correcting hypotension in clozapine intoxicated rats. 13 The most putative mechanism of ILE is the "lipid sink" theory. It suggests that intravascular lipid leads to redistribution of lipophilic drugs from the target tissues to the bloodstream down a concentration gradient.…”

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confidence: 99%

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Intravenous lipid emulsion as an adjuvant therapy of acute clozapine poisoning

et al. 2021

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Introduction: Clozapine is a frequently prescribed atypical antipsychotic drug. Various case reports documented the successful recovery of acute antipsychotics toxicity in association with the administration of intralipid emulsion (ILE). Aim: This study aimed to assess the adjuvant therapeutic role of SMOF Lipid administration on the outcomes of acute clozapine poisoning. Methods: Forty patients with acute clozapine poisoning were randomly allocated into two equal groups. The control group received the standard supportive treatment only, whereas the intervention group received the standard supportive treatment plus SMOF Lipid 20% infusion. All patients were subjected to history taking, full clinical examination, and laboratory investigations. The study outcomes were evaluated. Results: The mean Glasgow Coma Scale (GCS) at 6 hours (13.1 ± 2.3 vs 9.2 ± 2, p < 0.001) and 12 hours (14.3 ± 1.5 vs 9.6 ± 2, p < 0.001) after admission was significantly higher in the intervention group compared to the control group. The intervention group showed a significantly lower frequency of prolonged QTc interval 12 hours after admission (p = 0.003), as well as a significantly shorter hospital stay (p < 0.001). Conclusions: SMOF Lipid infusion seemed to have improved GCS, the prolonged QTc interval, and shortened the length of hospital stay. Furthermore, there were no adverse effects related to its administration.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Intravenous lipid emulsion as an adjuvant therapy of acute clozapine poisoning

et al. 2021

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“…Lipophilic medications such as haloperidol may be drawn into to the lipid sink, thus being removed from the circulation. 11,12 One previous patient case reported the successful resuscitation of a patient with haloperidol-induced cardiac arrest. 13…”

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confidence: 99%