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.

中文翻译：

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静脉脂肪乳辅助治疗急性氯氮平中毒

介绍：

氯氮平是一种常用的非典型抗精神病药物。各种病例报告记录了与使用脂肪乳剂 (ILE) 相关的急性抗精神病药物毒性的成功恢复。

目的：

本研究旨在评估 SMOF 脂质给药对急性氯氮平中毒结果的辅助治疗作用。

方法：

将 40 名急性氯氮平中毒患者随机分为两组。对照组仅接受标准支持治疗，而干预组接受标准支持治疗加SMOF Lipid 20%输注。所有患者均接受病史采集、全面临床检查和实验室检查。评估了研究结果。

结果：

与干预组相比，入院后 6 小时（13.1 ± 2.3 vs 9.2 ± 2，p < 0.001）和 12 小时（14.3 ± 1.5 vs 9.6 ± 2，p < 0.001）的平均格拉斯哥昏迷量表 (GCS) 显着更高到对照组。干预组入院后 12 小时 QTc 间期延长频率显着降低（p = 0.003），住院时间显着缩短（p < 0.001）。

结论：

SMOF 脂质输注似乎改善了 GCS、延长了 QTc 间期并缩短了住院时间。此外，没有与给药有关的副作用。