Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Dose-dependent clozapine-induced skin picking and self-injurious behaviour in treatment-resistant schizophrenia(The Kandy Society of Medicine, 2020) Rathnayake, L.C.; Chandradasa, M.; Mendis, J.Clozapine is a second-generation antipsychotic used for treatment-resistant schizophrenia. Obsessive-compulsive symptoms induced by clozapine is a known entity. Skin-picking is closely related to obsessions and excoriation disorder is now categorised under obsessive-compulsive and related disorders. Skin-picking associated with clozapine dose increments has been reported in a young male from India. Apart from this, skin-picking and self-injurious behaviour associated with clozapine use are not well described in the literature. Here we report a young Sri Lankan male with treatment-resistant schizophrenia presenting with self-injurious behaviour that is related to clozapine-induced compulsive skin-picking. Due to the partial response, clozapine dose of the described patient was increased above 550 mg/day. Skin-picking was seen only above this dose and the addition of risperidone helped to resolve the psychotic symptoms and keep the clozapine dose at the previous level. The current report is unique in the sense that the self-injurious behaviour was associated with clozapine dose increments.Item A case of hypotension and heart rate changes on rechallenge with a low dose of clozapine with no apparent secondary cause(Sri Lanka College of Psychiatrists, 2022) Harshini, M.L.; Fernando, A.I.W.; Abayawickrama, H.M.T.S.; Ikram, M.I.N.; Rajapakse, S.; Hapangama, A.Clozapine is known to cause innocuous as well as severe and or fatal cardiovascular side effects. These side effects are commonly reported at the initiation of clozapine therapy. We report a patient who was stable on clozapine for several years but in whom we had to withhold clozapine for medical reasons and subsequently developed significant hypotension and heart rate changes when rechallenged with a small dose of clozapine.