Suspected clozapine poisoning in the UK/Eire, 1992–2003

Flanagan, Robert J.; Spencer, Edgar P.; Morgan, Phillip E.; Barnes, Thomas R. E.; Dunk, Linda P.

doi:10.1016/j.forsciint.2004.10.024

Cited by 51 publications

(38 citation statements)

References 34 publications

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“…In the literature, nine cases of fatal intoxication with concentrations of 1.2-13µg/ml (mean, 5.2µg/ml) were reported; however, in cases of survived clozapine intoxication, a blood concentration of 3.5-9.5µg/ml has also been described [3,13].…”

Section: Discussionmentioning

confidence: 99%

Unassisted smothering in a pillow

et al. 2009

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We report the case of a 33-year-old man admitted to a psychiatric hospital because of paranoid schizophrenia. The man was found dead lying in his bed with the face pressed against a pillow and with elevated buttocks. The autopsy did not reveal a cause of death. The histological findings displayed the signs of the haemorrhagic-dysoric syndrome with acute emphysema; these findings are pathognomonic of obstructive asphyxia. The adverse effects of the neuroleptics demonstrated by the toxicological findings may have accelerated the loss of consciousness and facilitated the unusual position of the body. On the basis of the clinical history, the autopsy findings, the histological features and the toxicological results, asphyxia due to smothering was diagnosed as the cause of death.

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Section: Discussionmentioning

confidence: 99%

Unassisted smothering in a pillow

et al. 2009

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“…In documented fatal poisonings with clozapine, according to various investigators, the blood of the victims showed the concentrations as ranging between 1.2 and 13 mg/l [22,23]. Whole blood clozapine concentrations associated with acute toxicity in man are usually above 2 mg/l [21]. Flanagan et al determined the range of blood concentrations of clozapine as 3.7-12 mg/l, n = 7, and for norclozapine as 1.4-2.4, n = 6, with the range of clozapine to norclozapine concentration ratio of 1.4-2.4.…”

Section: Discussionmentioning

confidence: 99%

“…They may result from overdoses of clozapine alone [17][18][19][20][21][22][23][24] or a mixture of medications that included clozapine [25][26][27][28], or else they may be a consequence of complications [29,30]. Nonetheless, in rare cases, people have died as a result of taking atypical antipsychotic drugs, such as for example clozapine at therapeutic and supratherapeutic doses [19,31].…”

Section: Discussionmentioning

confidence: 99%

“…As it was suggested by Flannagan et al [21], in each case it is important to distinguish between clozapine self-poisoning and death possibly arising from clozapine toxicity during an ostensibly appropriate use of the drug. When attempting to distinguish between clozapine self-poisoning and clozapine toxicity, a factor to be taken into consideration is the grater acute toxicity of clozapine in naive subjects, including patients prescribed clozapine who have stopped taking the drug or who are taking only a small portion of the prescribed dose.…”

Section: Discussionmentioning

confidence: 99%

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Neonatal death following clozapine self-poisoning in late pregnancy

Kłys

Rojek

Rzepecka-Woźniak

2007

Forensic Science International

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“…Ce médicament a été à l'origine de nombreux cas d'intoxications chez l'adulte et chez l'enfant, dont certaines étaient fatales [1][2][3]. Soixante-treize cas d'intoxication à la clozapine ont été enregistrés en Allemagne en 2005, dont 62 intoxications chez des adultes [4].…”

Section: Introductionunclassified

Évaluation d’une méthode de dosage de la clozapine par spectrophotométrie UV

Teyeb

Najjar

2011

Ann Toxicol Anal

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Résumé -La clozapine, principal neuroleptique indiqué dans le traitement de la schizophrénie résistante, est à l'origine de nombreux cas d'intoxications accidentelles ou volontaires, d'où l'intérêt de son dosage. Notre travail a pour objectif la mise au point d'une méthode de dosage permettant le diagnostic d'une intoxication par la clozapine. La méthode est basée sur la lecture de l'absorbance, à 365 nm, du produit de la réaction entre la clozapine et l'iode dans le dichlorométhane. Les résultats ont montré que cette méthode de dosage est linéaire de 15 à 400 mg/L (r = 0,995), avec une limite de détection de 10,42 mg/L. La précision et l'exactitude ont été meilleures dans la zone de 120 à 400 mg/L. Le rendement de l'extraction, par l'éther, à partir des urines est en moyenne de 77,7 %. Cette méthode permet le dosage de la clozapine dans les urines, les comprimés et dans les échantillons post mortem en cas d'intoxication mortelle à la clozapine. Mots clés : Clozapine, spectrophotométrie UV, dichlorométhane, iodeAbstract -Clozapine, the principal neuroleptic indicated in the treatment of resistant schizophrenia, is implicated in many cases of accidental or voluntary intoxications. Thus, this drug should be dosed. In this work, the dosage of clozapine by UV spectrophotometry was studied to perfect a method allowing the diagnosis of intoxication or an overdose. The method is based on the reading of the absorbance of the product of the reaction between clozapine and iodine in dichloromethane at 365 nm. The results showed that this method is linear from 15 to 400 mg/L (r = 0.995), with a detection limit of 10.42 mg/L. Precision and accuracy were better between 120 and 400 mg/L. The extraction yield, by ether, from urine is on average 77.7%. This method allows the dosage of clozapine in urine, tablets and in post mortem samples in the case of clozapine fatal intoxication.

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Suspected clozapine poisoning in the UK/Eire, 1992–2003

Cited by 51 publications

References 34 publications

Unassisted smothering in a pillow

Unassisted smothering in a pillow

Neonatal death following clozapine self-poisoning in late pregnancy

Évaluation d’une méthode de dosage de la clozapine par spectrophotométrie UV

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