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DOI: 10.1055/a-0884-3980
Anstieg des Clozapinspiegels bei bronchopulmonalen Infekten: Häufiger als man denkt!
Increased Clozapine Levels During Infection: more Frequent than Assumed?Publication History
Publication Date:
03 July 2019 (online)
![](https://www.thieme-connect.de/media/psychiat-praxis/201905/lookinside/thumbnails/825_10-1055-a-0884-3980-1.jpg)
Zusammenfassung
Systemische Entzündungsreaktionen können über eine Hemmung der Cytochrom-P450-Proteine die Metabolisierung verschiedener Arzneimittel beeinflussen. Hier berichten wir über 2 Patienten mit schizophrener Psychose, die während eines pulmonalen Infekts stark erhöhte Clozapinspiegel, jedoch ohne klinisch sichtbare Nebenwirkungen, aufwiesen. Nach antibiotischer Behandlung und Reduktion der Clozapindosis normalisierte sich der Clozapinspiegel nach wenigen Tagen. Bei systemischen Infekten sollte an die Möglichkeit eines erhöhten Clozapinspiegels gedacht werden.
Abstract
Systemic infections are known to alter the metabolism of various drugs via inhibition of the cytochrome P450 family. Here, we report the cases of two patients with schizophrenic psychosis and highly elevated clozapine levels during pulmonary systemic infection, however without experiencing side effects. After antibiotic treatment and temporary reduction of clozapine dosage blood levels of clozapine normalized within a few days. These cases show that clozapine levels may be highly elevated without necessarily causing side effects and that intensified pharmacovigilance should be considered by the clinician in patients with systemic infections.
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