A Case Report of a Patient with Soaring Clozapine Levels after Developing a Urinary Tract Infection

Table 1

The patient’s levels of clozapine and other markers were monitored over the course of several weeks.

Date	Reference interval	Baseline	Week of Presentation	Week 4	Week 7	Week 11	Week 12	Week 14	Week 18
Dose of clozapine	200–450 mg/day	200	350	350	350	350	0	350	350
Clozapine concentrations	350–420 μg/L	475	666	726	661	1409	—	578	598
Norclozapine concentrations	—	390	384	391	437	742	—	359	373
CRP	<10 mg/L	—	—	—	—	17	—	9	—
ESR	<30 mm/hr	—	—	—	—	63	—	23	—
WBC	4.5–11.0 × 10^9/L	—	—	—	—	14.7 × 10^9/L	—	4.7 × 10^9/L	—
Neutrophils	2–7.5 10×^9/L	—	—	—	—	11.1 × 10^9/L	—	2.1 × 10^9/L	—
GGT	<30 IU/L	—	—	—	—	70 IU/L	—	26 IU/L	—
Urine leukocytes	0–5 × 10^6/µL	—	—	—	—	70 × 10^6/µL	—	3 x 10^6/µL	—
Urine erythrocytes	0–5 RBC/µL	—	—	—	—	10 RBC/µL	—	2 RBC/µL	—
Side-effects	—	—	—	—	—	Mild sedation	—	—	—
Somatic symptoms	—	—	—	—	—	Mild burning micturation	—	—	—

Abbreviations. CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; WBC, white blood corpuscles; GGT, gamma-glutamyl transferase; IU, international units; RBC, red blood corpuscles.