ACUTE HEPATITIS AFTER CLOZAPINE ADMINISTRATION

The authors present a case report of a cocaine abuser who developed ac ute hepatitis and an extrapyramidal reaction after administration of c lozapine, a novel dopamine antagonist. Previous clinical experience wi th clozapine is reviewed. Both clozapine and cocaine undergo hepatic m etabolism, increasing the potential for hepatotoxicity in selected pat ients. The authors also review hepatic metabolism of biogenic amines, their central nervous system effects, and the pharmacologic effects of clozapine and other abused substances on bioamine metabolism. Substan ce abusers' high susceptibility to hepatotoxicity highlights the need for careful monitoring for this form of liver dysfunction when adminis tering clozapine.