Transient parotitis in the course of clozapine treatment: a case report and review of the literature

Abstract

Introduction: Clozapine is an atypical antipsychotic, treatment of choice for patients unresponsive to, or intolerant of other antipsychotic drugs. While most of the adverse effects of clozapine are well discussed in the literature, clozapine-induced parotitis emerges as an uncommon complication, which clinicians should be aware of. Aim: The aim of this report is, by illustrating a case of clozapine-induced parotitis and reviewing the literature on the topic, to bring awareness of the occurrence of this potential adverse effect of clozapine treatment. Case Presentation: Due to poor response to several adequate trials with different antipsychotic medications a 57-year-old female with schizoaffective disorder was initiated on clozapine in 2008. The psychiatric condition of the patient notably improved in the following years. In 2016, after a decrease in her psychotropic therapy, the patient was hospitalized, and while restoring treatment with clozapine and divalproex she complained of increased salivation combined with painful bilateral parotid enlargement. The diagnosis of clozapine-induced parotitis was suggested. The medical condition had a favorable outcome within five days after administration of symptomatic medication. Conclusion: Adherence to drug treatment in psychiatric patients can be significantly improved if patients are well informed about the potential adverse effects of the administered medications and if the clinicians recognize and try to resolve them. Monitoring both common and rare adverse effects of clozapine treatment will give patients a chance of better therapy management.