A Case of Clozapine Induced Mania-Like Symptoms in the Treatment of Schizophrenia

Clozapine is an atypical antipsychotic and is the drug of choice for treatment-resistant schizophrenia. Unlike other atypical antipsychotics which are known to occasionally cause symptoms of mania or hypomania, clozapine has been shown to be effective at symptom reduction during manic episodes in treatment-resistant bipolar disorder and is generally well tolerated in those severe mood disorders. To our knowledge, there is only one other reported case of potential clozapine-induced mania. In this case report and review, we present a 47-year-old caucasian male with a well-established history of schizophrenia who was voluntarily admitted to an inpatient psychiatric unit for paranoia and auditory hallucinations. The patient had trialed multiple antipsychotics prior to the current hospitalization, with the exception of clozapine. To our knowledge, this is the second case report of manic-like symptoms that may be secondary to clozapine.