Year: 2026
Type: article
Study design: Case Report
Abstract: Introduction: Clozapine has been exceptionally reported as a cause of acute pancreatitis (AP), which may range from mild to severe.In this case presentation, a case of acute pancreatitis developing due to clozapine will be presented.Case: A 45-year-old male patient who had been followed for approximately 20 years with a diagnosis of Schizophrenia was hospitalized due to treatment noncompliance and resistant psychotic symptoms, and Clozapine was initiated at 25 mg/day and titrated to 75 mg/day.On the 13th day of treatment, fever elevations between 37.7-38.8°Cwere observed; infection, myocarditis, and neuroleptic malignant syndrome were ruled out, and clozapineinduced fever was considered, leading to a dose reduction to 50 mg/day.Three days after discharge, the patient presented with complaints of nausea, loss of appetite, and fever; laboratory tests revealed amylase 56 U/L and lipase 225 U/L; abdominal ultrasonography demonstrated increased thickness of the pancreatic head and body and decreased parenchymal echogenicity, and a diagnosis of Acute pancreatitis was made.No alcohol use, hypertriglyceridemia, or biliary pathology was detected.Clinical remission was achieved after discontinuation of clozapine.Discussion: Clinically, acute pancreatitis (AP) is diagnosed by the presence of typical abdominal pain accompanied by a threefold increase in serum amylase or lipase levels above the normal range.In a study investigating the causes of acute pancreatitis, medications were reported to account for only 3.4% of the possible etiologies.Although the number of reported cases in the literature is limited, current data suggest that clozapine-associated acute pancreatitis is a rare but clinically serious adverse effect.In the eight published cases, pancreatitis developed during clozapine treatment and regressed following discontinuation of the drug.The absence of other etiological factors and the recurrence of pancreatitis in some cases after rechallenge strongly support a causal relationship between clozapine and pancreatitis.amylase, lipase should be monitored weekly during clozapine titration
Source: Journal of Clinical Psychiatry
Language: English
Open Access status: diamond
OpenAlex ID: W7223186936