A Case of Clozapine-induced fatal bowel infarction after more than a 13-year treatment

Clozapine is a second-generation (atypical) antipsychotic agent, commonly prescribed for patients with treatmentrefractory schizophrenia [1]. Clozapine has a wide range of side effects, such as agranulocytosis, seizures, sialorrhea, constipation, weight gain, and hypotension. Among them, constipation is a common side effect of clozapine, and up to 60% of patients treated with clozapine experience constipation [1, 2]. Constipation can progress to distention and necrosis of the bowel following with peritonitis and sepsis, which revealed fatal outcome of clozapine-induced constipation [1, 3, 4]. Many reports exist in describing life-threatening gastrointestinal hypomotility caused by clozapine. Case reports about clozapine-induced bowel infarction mostly focus on treatment of clozapine less than five years [3, 5-7]. Here, we now present a 58-year-old female patient who experienced sudden death due to bowel infarction and sepsis after a 13 years of clozapine treatment.