{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:17:39Z","timestamp":1760660259338,"version":"build-2065373602"},"reference-count":16,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T00:00:00Z","timestamp":1757203200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>We describe a case of a 56\u2010year\u2010old male who developed severe, refractory hypotension after an intentional ingestion of clozapine and who became hemodynamically stable after one session of therapeutic plasma exchange (TPE). The patient, who presented after an ingestion of clozapine, was found to have altered mental status and hypotension in the emergency department. Escalating catecholamine vasoactive agents were necessary to maintain adequate hemodynamics. Angiotensin II was added and rapidly up titrated in efforts to maintain adequate blood pressure. Due to persistent hemodynamic instability despite four vasoactive agents, TPE was attempted to enhance the elimination of the highly protein bound medication. Within 2\u2009h of completing TPE, the catecholamines and vasopressin were stopped, and angiotensin II dosing was significantly decreased. This is the first report of utilizing TPE as a method of enhanced elimination of a toxic clozapine ingestion resulting in severe hemodynamic compromise. Further study is necessary to determine if TPE should be incorporated into the care of patients experiencing clozapine toxicity.<\/jats:p>","DOI":"10.1002\/phar.70057","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T10:34:52Z","timestamp":1757327692000},"page":"706-710","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Use of Plasma Exchange for Clozapine Intoxication: A Case Report"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0101-8320","authenticated-orcid":false,"given":"Bradley J.","family":"Peters","sequence":"first","affiliation":[{"name":"Department of Pharmacy Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luz Y.","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine, Department of Laboratory Medicine and Pathology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca L.","family":"Lange","sequence":"additional","affiliation":[{"name":"Minnesota Regional Poison Center Hennepin Healthcare  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie W.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Misbah","family":"Baqir","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,7]]},"reference":[{"volume-title":"Clozaril (Clozapine). 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