Clozapine-Induced Pulmonary Embolism: A Case Report and Literature Review

Purpose: To report a case of pulmonary emboli induced by clozapine in a patient who was also using nicotine gum. This case is presented to alert health care providers of this rare adverse effect, to call attention to the risks associated with thromboembolism, and to enable prompt recognition of symptoms so that morbidity and mortality may be decreased in future cases.Summary: A 51-year-old white woman was admitted to the psychiatric ward of a hospital for depression. She had suicidal ideation, was experiencing ethanol abuse relapse, and had had auditory hallucinations caused by concomitant medication nonadherence for 2 weeks prior to admission. The patient smoked 2 packs of cigarettes per day and was adhering to a smoking cessation program that included the use of nicotine gum. She developed diffuse pulmonary emboli 15 days after clozapine initiation. Application of the Naranjo Adverse Drug Reaction Probability Scale to this case indicated a probable relationship between initial clozapine titration and th...