A 30-year-old male patient with paranoid schizophrenia was on clozapine therapy for
more than five years. Discontinuation of clozapine and an attempt to change his medication
to sertindole has led to serious psychotic and somatic symptoms. After readministration
of clozapine the psychotic symptoms rapidly disappeared. The patient was monitored
by BPRS and PANSS positive and negative scale. Also clinical and labor parameters
of the patient were monitored. The change of his medication from clozapine to sertindole
was unsuccessful. This case report suggests that although atypical antipsychotics
may be generally different from the classical neuroleptic drugs, there are also significant
differences among the atypical antipsychotic drugs in their effects on the receptors
of the central nervous system. Therefore the change of clozapine to another atypical
antipsychotic medication in the clinical practice should be cross-tapered and the
symptoms of withdrawal closely monitored.
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Ph.D. M.D., István Degrell
University Medical School of Debrecen Department of Psychiatry
98, Nagyerdei krt. H-4012 Debrecen Hungary
Email: degrell@psychiatry.dote.hu.
