Adverse effects of Clozapine Mnemonic

Worthwhile TEACHINGS

Weight gain

Tachycardia

Eneuresis

Agranulocytosis

Constipation

Hypo/hypertension, hypersalivation

Increased temperature

Nausea

GORD

Seizures

Clozapine Induced Gastric Hypomotility

Previous data indicated that most severe cases of CIGH occur during the first four months of treatment (Palmer, McLean, Ellis, & Harrison-Woolrych, 2008; West, Rowbotham, Xiong, & Kenedi, 2017) However, a more recent study (Every-Palmer & Ellis, 2017) of clozapine-induced serious or fatal ‘slow gut’ adverse reactions revealed remarkably contrasting outcomes.

This was the largest study to date on the problem and studied one-sixty accounts of serious CIGH out of about forty-three thousand patients exposed to clozapine. Fatalities occurred in at least twenty-nine patients. This sums to a prevalence of thirty-seven per ten-thousand and the case-fatality ratio of eighteen per cent. The duration of treatment when the serious cases occurred ranged from three days to eighteen years with a median of two-and-a-half years. However, the median duration of onset was over four years in cases with a fatal outcome and two years in those with a nonfatal or unknown outcome. The odds ratio of fatal outcomes rose by twenty-one percent every two years. Thus, serious CIGH can occur during the treatment, and the cases presenting later may be at higher risk of death.

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