Marked Elevation of Creatine Kinase with Sertindole: A Case Report

Case Report

This is the case of a 23-year-old female with a history of disorganized schizophrenic disorder, refractory to a multitude of antipsychotic agents received since the age of 15 including a variety of both typical and atypical ones. After a preliminary clinical and laboratory work-up which yielded uniformly negative findings only, including creatine kinase (CK) serum levels, the patient was prescribed sertindole at an initial dosage of 4 mg/d. However, in a subsequent clinical and laboratory work-up one week later, just before titrating her medication upwards, CK levels were found to be markedly elevated (3.500 IU/L), without any other abnormal findings. Sertindole was immediately discontinued and CK levels decreased to the normal range within three days.

References

• 1 Devarajan S, Dursun SM. Antipsychotic drugs, serum creatinine kinase (CPK) and possible mechanisms (letter to the editor).  Psychopharmacology. 2000;  152 122
• 2 Holtmann M, Meyer AE, Pitzer M, Schmitt MH. Risperidone-induced marked elevaton of serum creatine kinase in adolescence: a case report.  Pharmacopsychiatry. 2003;  36 317-318
• 3 Klein JP, Fielder U, Appel H, Quante A, Jockers-Scherubl MC. Massive creatine kinase elevations with quetiapine: report of two cases.  Pharmacopsychiatry. 2006;  39 39-40
• 4 Meltzer HY. Massive serum creatine kinase increases with atypical antipsychotic drugs: what is the mechanism and the message?.  Psychopharmacology. 2000;  150 349-350
• 5 Meltzer HY, Cola PA, Parsa M. Marked elevations of serum creatine kinase activity associated with antipsychotic drug treatment.  Neuropsychopharmacology. 1996;  15 395-405
• 6 Naranjo CA, Busto U, Sellers EM, Sandos P, Ruiz I, Roberts EA. et al . A method for estimating the probability of adverse drug reactions.  Clin Pharmacol Ther. 1981;  30 239-245

Correspondence