Tobacco and cannabis smoking cessation can lead to intoxication with clozapine or olanzapine

Details

Serval ID
serval:BIB_E52523D88082
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Tobacco and cannabis smoking cessation can lead to intoxication with clozapine or olanzapine
Journal
International clinical psychopharmacology
Author(s)
Zullino D.F., Delessert D., Eap C.B., Preisig M., Baumann P.
ISSN
0268-1315
Publication state
Published
Issued date
2002
Peer-reviewed
Oui
Volume
17
Number
3
Pages
141-143
Language
english
Notes
Publication types: Case Reports ; Journal Article - Publication Status: ppublish
Abstract
Plasma levels of clozapine and olanzapine are lower in smokers than in nonsmokers, which is mainly due to induction of cytochrome P4501A2 (CYP1A2) by some smoke constituents. Smoking cessation in patients treated with antipsychotic drugs that are CYP1A2 substrates may result in increased plasma levels of the drug and, consequently, in adverse drug effects. Two cases of patients who smoked tobacco and cannabis are reported. The first patient, who was receiving clozapine treatment, developed confusion after tobacco and cannabis smoking cessation, which was related to increased clozapine plasma levels. The second patient, who was receiving olanzapine treatment, showed important extrapyramidal motor symptoms after reducing his tobacco consumption. The clinical implication of these observations is that smoking patients treated with CYP1A2 substrate antipsychotics should regularly be monitored with regard to their smoking consumption in order to adjust doses in cases of a reduction or increase in smoking.
Keywords
Adult, Antipsychotic Agents, Basal Ganglia Diseases, Benzodiazepines, Clozapine, Confusion, Cytochrome P-450 CYP1A2, Humans, Male, Marijuana Smoking, Pirenzepine, Smoking, Smoking Cessation
Pubmed
Web of science
Create date
10/03/2008 10:53
Last modification date
20/08/2019 16:08
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