Case Report
Copyright ©The Author(s) 2021.
World J Clin Cases. Jul 16, 2021; 9(20): 5611-5620
Published online Jul 16, 2021. doi: 10.12998/wjcc.v9.i20.5611
Table 2 Case reports of clozapine-related seizure published in last 20 years
Ref.
Year
Age
Gender
Dose of clozapine
Blood concentration of clozapine
Blood concentration of norclozapine
Type of seizure
EEG
Antiepileptic drugs
Further use of clozapine
Other psychiatric drugs
Usiskin et al[47]200015M400 mg/d--Myoclonus and GTCSBihemispheric epileptiform activityGabapentin 2100 mg/dClonazepam 2 mg/d300 mg/d Olanzapine 25 mg/d
Navarro et al[48]200123F200 mg/d--GTCSBihemispheric epileptiform activityTopiramate 200 mg/d 200 mg/d-
Haberfellner[31]200229F150 mg/d--Myoclonus and GTCSParoxysmal generalized spikes-100 mg/dHaloperidol 10 mg/d
Duggal et al[49]200228M300 mg/d--Stuttering ----
425 mg/d--GTCSGeneralized nonparoxysmal slowing and a photic convulsive response Valproate 800 mg/d300 mg/d-
Foster et al[50]200532F125 mg/d--TCS----
237.5 mg/d--TCS-Valproate 500 mg/d450 mg/dCitalopram 20 mg/d
Begum et al[51]2005--300 mg/d--Myoclonus and stuttering-Valproate 400 mg/d300 mg/d-
Muzyk et al[52]201020M600 mg/d--Myoclonus and GTCS-Lamotrigine 200 mg/d550 mg/dLithium 900 mg/d
Praharaj et al[32]201038M250 mg/d--MyoclonusBilateral frontal theta waves and sharp–slow waveClonazepam 1000 mg/d250 mg/d-
Horga et al[33]201015M350 mg/d--Speech dysfluency and myoclonus--300 mg/dClomipramine 225 mg/d
300 mg/d--GTCSGeneralized andMultifocal paroxysmal epileptiform discharges Sodium valproate 500 mg/d300 mg/dClomipramine 225 mg/d
Leung et al[53]201452F450 mg/d1400 ng/mL (36 h after the last dose)606 ng/mL (36 h after the last dose)Myoclonus--225.5 mg/d-
Park et al[34]201426F450 mg/d--GTCS--300 mg/d-
300 mg/d--GTCSNo epileptiform dischargeValproate 250 mgDrug withdrawalECT, risperidone 6 mg/d, escitalopram 15 mg/d
Kikuchi et al[35]201419-48F (n = 12)275-600 mg/d--TCS and myoclonic (n =1) TCS (n = 1) Myoclonic (n = 4)Spike and slow waveLamotrigine 150-300 mg/d (n = 2) Valproate 400-800 mg/d (n = 3)200-550 mg/d-
Grover et al[6]201524-63F (n = 3) M (n = 9)150-600 mg/d--GTCS (n = 12)-Lamotrigine (n = 1) Valproate 1000 mg/d (n = 3)150-600 mg/dHaloperidol (n = 1) Sertraline 75 mg/d (n = 1)
Osborne et al[41]201520M400 mg/d140 ng/mL130 ng/mLMyoclonus----
400 mg/d180 ng/mL150 ng/mLGTCS-Valproate 1000 mg/d475 mg/d-
Bolu et al[29]201729M200 mg/d--TCSBilateral diffuse epileptic activityValproate 1000 mg/d100 mg/d-
Rachamallu et al[54]201716M350 mg/d--Orofacial dyskinesia with perioral twitching----
400 mg/d--StutteringSeveral episodes of generalized spike Valproate 1000 mg/d450 mg/d-
Borah et al[30]201942F300 mg/d--Twitching and urinary incontinence--250 mg/dHaloperidol 10 mg/d
Chochol et al[55]201957M600 mg/d866 ng/mL301 ng/mLMyoclonus and stutteringBilateral sharp waves and slow wave complexes-300 mg/dRisperidone 1.5 mg/d, Risperidone 37.5 mg every 2 wk
EEG: Electroencephalogram; M: Male; F: Female; GTCS: Generalized tonic-clonic seizure; TCS: Tonic-clonic seizure; ECT: Electroconvulsive therapy.