Clozapine-induced intestinal occlusion: a serious side effect.

Aim of this article is to describe the first italian case reported in literature of a clozapine-induced intestinal occlusion with previous severe constipation in a 45-year-old male patient who had been treated with daily clozapine for 5 months because of treatment-resistant residual schizophrenia. When conservative treatment (intravenous fluids, fleet enema and rectal washout) was used and clozapine therapy was decreased, gastrointestinal symptoms rapidly improved and the patient had regular bowel motions within a week. Preventive measures (high-fiber diet, adequate fluid intake, stool softeners and exercise) was also used to ensure that clozapine therapy could be safely continued. Although constipation is a common and usually benign side effect of treatment with clozapine, this case-report highlights the consequences of undertreated and unrecognized marked constipation progressing to severe bowel obstruction (a complication which deserves more attention because it can lead to hospitalization and might be potentially fatal).

Drug-induced systemic lupus erythematosus after 7 years of treatment with carbamazepine.

Aim of this work is to describe a late-onset of carbamazepine-induced systemic lupus erythematosus (SLE) in a 38-year-old female patient who had been treated with daily carbamazepine (CBZ) for 7 years because of a bipolar I disorder. When CBZ was discontinued, symptoms rapidly improved and antinuclear antibodies (ANA) disappeared. So far, only few cases have been reported of CBZ-induced SLE within months after the beginning of treatment. This is the second (first italian) case report in literature about CBZ-induced SLE with serological confirmation after years of treatment without previous side effects.