Study of the Correlation between clozapine levels and clinical findings in acutely intoxicated patients admitted to Poison Control Center-Ain Shams University Hospitals: 6 months (A prospective Study)

Document Type : Original Article


Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine-Ain Shams University, Cairo Egypt.


Background: Clozapine (CLZ) superior efficacy compared to other antipsychotics is well established. Unlike other antipsychotic medications, a safe therapeutic blood level range for clozapine has not been clearly established. Objective: This study was undertaken as a trial to evaluate the potential correlation between clinical findings and CLZ blood levels in patients with acute CLZ toxicity. Methodology: A prospective study was conducted on all patients of both sexes with history of acute clozapine overdose, admitted to Poison Control Center of Ain Shams University Hospitals (PCC-ASUH) from the first of March 2019 to the end of August 2019. The total number of acutely intoxicated clozapine cases in this study was 25 patients, number admitted in 6 months period. The data collected for each patient included socio-demographic data, clinical data (intoxication data and clinical examination), laboratory investigation (including blood clozapine level), ECG, treatment, and outcome. Results: The results showed that there was no statistically significant correlation between the blood level of clozapine and any of the studied parameters, except with the level of consciousness, where there was statistically significant increase in the level of clozapine in comatose patients compared to conscious ones. Conclusion: It was concluded that the study suggests that there could be a potential benefit of blood clozapine level as a predictor and prognostic marker of coma in acute clozapine overdose.
Received in original form: 30 Augest 2021 Accepted in a final form: 30 October 2021