Intravenous lipid emulsion as an adjuvant therapy of acute clozapine poisoning

Introduction: Clozapine is a frequently prescribed atypical antipsychotic drug. Various case reports documented the successful recovery of acute antipsychotics toxicity in association with the administration of intralipid emulsion (ILE). Aim: This study aimed to assess the adjuvant therapeutic role...

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Bibliographic Details
Published in:Human & experimental toxicology 2021-07, Vol.40 (7), p.1053-1063
Main Authors: Elgazzar, Fatma M, Elgohary, Mona S, Basiouny, Sara M, Lashin, Heba I
Format: Article
Language:English
Subjects:
Adjuvant therapy
Adolescent
Adult
Antidotes - therapeutic use
Antipsychotic Agents - poisoning
Antipsychotics
Case reports
Child
Child, Preschool
Clozapine
Clozapine - poisoning
Combined Modality Therapy
Egypt
Fat Emulsions, Intravenous - therapeutic use
Female
Fish Oils - therapeutic use
Humans
Intravenous administration
Lipids
Male
Olive Oil - therapeutic use
Patients
Poisoning
Poisoning - drug therapy
Soybean Oil - therapeutic use
Toxicity
Treatment Outcome
Triglycerides - therapeutic use
Young Adult
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Summary:Introduction: Clozapine is a frequently prescribed atypical antipsychotic drug. Various case reports documented the successful recovery of acute antipsychotics toxicity in association with the administration of intralipid emulsion (ILE). Aim: This study aimed to assess the adjuvant therapeutic role of SMOF Lipid administration on the outcomes of acute clozapine poisoning. Methods: Forty patients with acute clozapine poisoning were randomly allocated into two equal groups. The control group received the standard supportive treatment only, whereas the intervention group received the standard supportive treatment plus SMOF Lipid 20% infusion. All patients were subjected to history taking, full clinical examination, and laboratory investigations. The study outcomes were evaluated. Results: The mean Glasgow Coma Scale (GCS) at 6 hours (13.1 ± 2.3 vs 9.2 ± 2, p < 0.001) and 12 hours (14.3 ± 1.5 vs 9.6 ± 2, p < 0.001) after admission was significantly higher in the intervention group compared to the control group. The intervention group showed a significantly lower frequency of prolonged QTc interval 12 hours after admission (p = 0.003), as well as a significantly shorter hospital stay (p < 0.001). Conclusions: SMOF Lipid infusion seemed to have improved GCS, the prolonged QTc interval, and shortened the length of hospital stay. Furthermore, there were no adverse effects related to its administration.
ISSN:0960-3271
1477-0903
DOI:10.1177/0960327120983873