C Reactive Protein and Clozapine- Induced Fever

Abstract

We report a case of recurrent clozapine-induced fever which was associated with a rise in C reactive protein (CRP). The patient was a 73-year-old man with Lewy Body dementia who was admitted for psychosis. He was treated with clozapine and developed a benign fever that was associated with a rise in CRP. The CRP initially normalized off clozapine. However, after the patient was rechallenged with clozapine, the CRP became elevated with a subsequent recurrence of fever. We postulate that the elevation in CRP and the subsequent fever were caused by the effects of clozapine on the cytokine system via interleukin- 6 and tumor necrosis factor-alpha resulting in an inflammatory response with an acute phase reaction.