Pulmonary embolism in a patient taking clozapine

doi:10.1136/bmj.39545.690613.47

BMJ 2008;336:1499-1501 (28 June), doi:10.1136/bmj.39545.690613.47

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Pulmonary embolism in a patient taking clozapine

Vinod H Srihari, assistant professor, T Warren Lee, assistant professor

¹ Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA

Correspondence to: V H Srihari vinod.srihari@yale.edu

The first 150 words of the full text of this article appear below.

A 45 year old man with schizophrenia began experiencing auditoryhallucinations at the age of 25. These were well controlledfor several years by a monthly intramuscular injection of haloperidoldecanoate. One year after he switched to oral haloperidol, theintensity of the hallucinations increased and included a voicecommanding him to end his life. Concerns for his safety ledto a brief admission to psychiatric hospital. When he had toreturn to hospital within a month, the inpatient psychiatristinferred a loss of response to haloperidol and encouraged thepatient to switch to clozapine. Six months later he was broughtto an emergency department in an acute confusional state aftera clozapine overdose. The drug was discontinued and his mentalstatus improved rapidly, but investigation of acute dyspnoeashowed bilateral pulmonary emboli. The patient was not overweightand had no history of recent surgery, trauma to the legs, or. . . [Full text of this article]

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