Risks and benefits of clozapine and lithium co-prescribing: A systematic review and expert recommendations

Verdoux, Hélène; Quilès, Clélia; León, José de

doi:10.1016/j.schres.2023.03.032

Cited by 6 publications

(1 citation statement)

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“…The most well-documented adverse effect linked with clozapine-lithium coprescription is an increased risk of neurotoxicity, and common presentations include myoclonus, ataxia, and seizures 12 . Whereas some authors suggested that monitoring of drug levels can be helpful in the early detection of neurotoxicity, 12 others recommend that patients on combined treatment should be monitored for incident central nervous system EEG changes when administering lithium in combination with clozapine regardless of plasma clozapine levels or the usage of ASMs 13 . Bender et al 14 concluded that clozapine-lithium coadministration is safe and effective, with enhanced efficacy compared with monotherapy.…”

Section: Discussionmentioning

confidence: 99%

Clozapine- and Lithium-Associated Myoclonus

Elmarasi,

Abdelhady,

Pathare

et al. 2023

J Clin Psychopharmacol

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M yoclonus is a brief, involuntary, and irregular jerking or twitching of a muscle or muscle group caused by sudden contractions or lapses of contraction. Several psychotropic medications, such as antidepressants, antipsychotics, lithium, and antiseizure medications (ASMs), can be associated with myoclonus individually or in combination. We describe the case of a patient who had been on lithium and clozapine separately without event but developed myoclonus when these agents were combined. The myoclonus persisted despite a dose reduction in clozapine but improved with a lowered dose of lithium, highlighting the synergism in their action.

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