Clozapine-Induced Fevers and 1-Year Clozapine Discontinuation Rate
J Clin Psychiatry 2002;63(10):880-884
© Copyright 2015 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Background: Clozapine-induced fever is a known
side effect that can occur during clozapine initiation. This
study aims to characterize patients who experience
clozapine-induced fever, the nature of the fevers, and rates of
clozapine continuation at 1 year in patients who develop fever
versus those who do not.
Method: A retrospective chart review of 93
consecutive clozapine initiations (1991-1999) was conducted.
Fever was defined as any 1 temperature at or above 38.0oC
(100.4oF). Demographic information, presence or
absence of clozapine-induced fevers, and continuation of
clozapine treatment at 1 year were extracted from the charts.
These variables were analyzed for significance, and subsample
analysis was conducted for those with more severe fevers (at or
above 38.5oC [101.3oF]).
Results: Of the 93 patients, 20.4% (N =
19) developed clozapine-induced fevers. At 1 year, there was no
significant difference in clozapine discontinuation rate between
those patients who experienced fever and those who did not.
Patients who experienced higher fevers ( 38.5oC [101.3oF])
tended to be significantly older than those who did not (p <
.027). The mean fever duration was 3.8 days (range, 1-9 days),
with a mean temperature of 39.1oC (102.4oF)
(range, 38.0-41.0oC [100.4-105.8oF]). At 1
year, the patients who experienced fever showed no increased risk
of severe reactions such as agranulocytosis. All patients with
fevers continued clozapine treatment with good 1-year
continuation rate on treatment with this medication.
Conclusion: Clozapine-induced fever is not an
indication for discontinuing this effective medication. It is a
benign, self-limited phenomenon not predictive of drug
discontinuation at 1 year. Older age at time of treatment may be
a risk factor for developing clozapine-induced fever.