Restricted accessResearch articleFirst published online 1995-1
Clozapine can cause hallucinations by inducing complex partial seizures of temporal lobe origin (temporal lobe epilepsy). A potentially serious complication in the management of schizophrenia with clozapine
A young man with schizophrenia had persistent auditory hallucinations which responded well to clozapine but subsequently developed a different pattern of brief, joint visual and auditory hallucinations which were confirmed as being due to complex partial seizures of temporal lobe origin. He had no history of epilepsy prior to taking clozapine and the subsequent hallucinations could be mistaken for a deterioration in the schizophrenia, leading to a further increase in clozapine dose.
Bogerts B., Ashtari M., Degreef G., Alvir J M J, Bilder R.M., Lieberman J.A. (1990) Reduced temporal limbic structure volumes on magnetic resonance images in first episode schizophrenia. Psychiatr Res: Neuroimaging35: 1-13
2.
Bruton C.J., Stevens J.R., Frith C.D. (1994) Epilepsy, psychosis, and schizophrenia: clinical and neuropathologic correlations. Neurology44: 34-42
3.
Devinsky O.Honigfield G., Patin J. (1991) Clozapine-related seizures. Neurology41: 369-371
4.
Flor-Henry P. (1969) Psychosis and temporal lobe epilepsy: a controlled investigation. Epilepsia10: 363-395
5.
Gouzoulis E., Ozdaglar A., Kasper J. (1993) Myoclonic seizures followed by grand mal seizures during clozapine treatment. Am J Psychiatr150: 1128
6.
Karagulla S., Robertson M.B. (1955) Psychical phenomena in temporal lobe epilepsy and the psychoses. Br Med J1: 748-752
7.
Shenton M.E., Kikinis R., Jolesz F.A., Seth D., Pollak M.A., LeMay M., Wible C.G., Hokama H., Martin J., Metcalf D., Coleman M., McCarley R.W. (1992) Abnormalities of the left temporal lobe and thought disorder in schizophrenia. N Engl J Med327: 604-612
8.
Slater E., Beard A.W. (1963) The schizophrenia-like psychoses of epilepsy. Br J Psychiatr109: 95-150
