Refractory hypotension treated with vasopressin after intentional clozapine overdose

摘要

We report the case of a 21-year-old schizophrenic woman presenting to an Emergency Department (ED) 2 h after intentional ingestion of 2300 mg (23 X 100 mg) of her own clozapine tablets. She did not have access to other medications. Her family found her in a drowsy state and she subsequently experienced a 5-min generalized tonic-clonic seizure. Paramedics found her to be unresponsive, tachycardic (130 beats/min) and hypotensive (80 mmHg systolic), with the latter responding to 1 liters of intravenous 0.9% saline. She further experienced a spontaneously resolving generalized tonic-clonic seizure en route to the ED.