Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark hill, London, SE5 9RS, UK.
South London and Maudsley NHS Foundation Trust, London, UK.
BMC Pharmacol Toxicol. 2020 May 20;21(1):35. doi: 10.1186/s40360-020-00413-6.
Acute pancreatitis is a rare but recognised complication of clozapine leading to termination of treatment.
We present the case of a 39-year-old man with treatment-resistant schizoaffective disorder and a history of recurrent acute pancreatitis attributed to clozapine. After 15 years of unremitting symptoms with disruptive and aggressive behaviour, he was admitted for a clozapine rechallenge. Despite experiencing two further episodes of acute pancreatitis during clozapine treatment that led to its temporary withdrawal, clozapine was successfully re-established under gastroenterology consultation with close monitoring which resulted in progressively marked improvement of his mental state.
This case demonstrates that patients who develop pancreatitis during clozapine treatment may be cautiously rechallenged with specialist gastroenterology support.
急性胰腺炎是氯氮平罕见但已被认识的一种并发症，可导致治疗终止。
我们报告了一例 39 岁男性，患有难治性精神分裂症谱系障碍，并有反复发作的急性胰腺炎，归因于氯氮平。在经历了 15 年持续不断的症状、具有破坏性和攻击性行为后，他因氯氮平再挑战而入院。尽管在氯氮平治疗期间经历了另外两次导致其暂时停药的急性胰腺炎发作，但在接受胃肠病学咨询和密切监测下，氯氮平再次成功建立，这导致他的精神状态逐渐显著改善。
本病例表明，在氯氮平治疗期间发生胰腺炎的患者可以在专家胃肠病学支持下谨慎地再挑战。
