Clozapine/haloperidol withdrawal
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Neonatal withdrawal syndrome following in utero exposure: case report A boy developed neonatal withdrawal syndrome following in utero exposure to clozapine and haloperidol. The boy was delivered naturally in the 39th week of gestation to a mother with a history of mental illness. During pregnancy, she had continued oral treatment with haloperidol 4mg and clozapine 50mg, each three times daily, and had last consumed the drugs 5 hours prior to labour. After birth, he nursed poorly and displayed weak sucking and swallowing motions. He had a seizure 30 hours after birth, at which time he had an absent stare, twitching of the arms and legs, and purple lips. He experienced a second seizure approximately 5 hours later and vomited once. He was hospitalised 38 hours after birth; at this time, he was easily irritated and had scattered bleeding spots on his frontal chest and four limbs. His toenails were slightly purplish, and his torso, face and lateral sclera had a yellowish discolouration. He had a flat anterior fontanelle and a bluish perioral area. His limb muscle tension was slightly high and mild pitted swelling was apparent in both lower limbs. He experienced another convulsion shortly after hospitalisation, at which point his eyes rolled upwards, his lips turned purple, and all four limbs were in spasms. The boy’s convulsion eased within 2 minutes of receiving phenobarbital sodium. A diagnosis of neonatal withdrawal syndrome was considered. Nutritional support, jaundice treatment and other therapies were provided. He had no further convulsions and nursed well. He was weaned of the medications and was discharged after 10 days. No abnormalities were apparent over 2 months of follow-up. Author comment: Neonatal withdrawal syndrome is caused when pregnant women consume sedatives, anaesthetics, analgesics or hallucinogens. Clozapine might lead to withdrawal symptoms if drug administration is stopped suddenly. Zhu MZ. Neonatal withdrawal syndrome associated with maternal clozapine and haloperidol therapy. Zhonghua Er Ke Za Zhi 49: 796-7, No. 10, Oct 2011 803074645 [Chinese; summarised from a translation] - China
0114-9954/10/1413-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 4 Aug 2012 No. 1413
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