Colon Perforation and Peritonitis Associated With Clozapine

Letter to the Editor

Sir: The antipsychotic clozapine can cause many adverse effects, most notably agranulocytosis and seizures. In addition to such effects on the hematopoietic system and the central nervous system, clozapine can seriously affect the gastrointestinal system: deaths from bowel obstruction, severe fecal impaction, and necrotizing colitis have been reported. To increase awareness of clozapine’s potent effects on the gut, we describe a case of a perforated colon and peritonitis associated with clozapine. Our patient survived, albeit with a markedly reduced quality of life.