{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T16:18:58Z","timestamp":1772813938615,"version":"3.50.1"},"reference-count":40,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2016,8,4]]},"abstract":"<jats:p>Dysphagia is listed as a \u2018rare\u2019 side effect following clozapine treatment. In this case report, we describe how significant clozapine-induced dysphagia has led to significant reduction of nutritional intake with subsequent substantial weight loss. An 18-year-old single man with an established diagnosis of treatment-resistant paranoid schizophrenia recovered well on a therapeutic dose of clozapine. However, he was noted to lose weight significantly (up to 20% of his original weight) as the dose was uptitrated. This was brought about by development of dysphagia, likely to be due to clozapine. Addition of nutritional supplementary liquids and initiation of a modified behavioural dietary\/swallowing programme, while repeatedly mastering the Mendelsohn manoeuvre technique, alleviated the swallowing difficulties and restored his weight.<\/jats:p>","DOI":"10.1136\/bcr-2016-216445","type":"journal-article","created":{"date-parts":[[2016,8,19]],"date-time":"2016-08-19T15:48:00Z","timestamp":1471621680000},"page":"bcr2016216445","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Clozapine-induced dysphagia with secondary substantial weight loss"],"prefix":"10.1136","volume":"2016","author":[{"given":"Mugtaba","family":"Osman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vekneswaran","family":"Devadas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,8,19]]},"reference":[{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.1","doi-asserted-by":"publisher","DOI":"10.1185\/03007999709113338"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.2","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldv017"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.3","doi-asserted-by":"publisher","DOI":"10.3371\/CSRP.HIFR.01062013"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.4","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.161.9.1620"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.5","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.105.092155"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3956(96)00039-8"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.7","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1016\/S0022-3565(25)38596-4","article-title":"Binding of typical and atypical antipsychotic agents to 5-hydroxytryptamine-6 and 5-hydroxytryptamine-7 receptors","volume":"268","author":"Roth","year":"1994","journal-title":"J Pharmacol Exp Ther"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.8","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2014.38"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.9","doi-asserted-by":"publisher","DOI":"10.1177\/0269881113515065"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-977X(99)00055-3"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.11","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-015-1807-1"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.12","doi-asserted-by":"publisher","DOI":"10.14503\/THIJ-13-3633"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.07.103"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.14","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v69n0509"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.15","first-page":"135","article-title":"[Dysphagia: definition]","volume":"48","author":"Arnold","year":"1991","journal-title":"Ther Umsch"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.16","unstructured":"Joint Formulary Committee. British National Formulary (2016). London, UK: BMJ Group and Pharmaceutical Press, issue 71, 2016:235."},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.17","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.2147\/NDT.S83989","article-title":"Rare and very rare adverse effects of clozapine","volume":"11","author":"De Fazio","year":"2015","journal-title":"Neuropsychiatr Dis Treat"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.18","doi-asserted-by":"publisher","DOI":"10.1007\/s40141-014-0061-2"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.19","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1288\/00005537-198704000-00014","article-title":"Function in the pharyngoesophageal segment","volume":"97","author":"Mendelsohn","year":"1987","journal-title":"Laryngoscope"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.20","doi-asserted-by":"publisher","DOI":"10.1177\/0269881109102530"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.21","first-page":"225","article-title":"Clozapine-induced weight loss?","volume":"23","author":"Appiani","year":"2011","journal-title":"Ann Clin Psychiatry"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/bcr.09.2011.4790","article-title":"Dramatic weight loss associated with commencing clozapine","volume":"2011","author":"Lally","year":"2011","journal-title":"BMJ Case Rep"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.23","first-page":"439","article-title":"Emergence of obsessive compulsive symptoms during treatment with clozapine","volume":"53","author":"Baker","year":"1992","journal-title":"J Clin Psychiatry"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.24","doi-asserted-by":"publisher","DOI":"10.1097\/YPG.0000000000000053"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2016.02.020"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.26","doi-asserted-by":"crossref","first-page":"212259","DOI":"10.7573\/dic.212259","article-title":"Tardive dyskinesia in patients treated with atypical antipsychotics: case series and brief review of etiologic and treatment considerations","volume":"3","author":"Kim","year":"2014","journal-title":"Drugs Context"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.27","first-page":"1","article-title":"An update on tardive dyskinesia: from phenomenology to treatment","volume":"3","author":"Waln","year":"2013","journal-title":"Tremor Other Hyperkinet Mov"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.28","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0b013e3181e5c0f7"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.29","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2012.01920.x"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.30","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-005-0248-4"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.31","doi-asserted-by":"publisher","DOI":"10.1016\/S0014-2999(99)00341-6"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.32","doi-asserted-by":"publisher","DOI":"10.1016\/0922-4106(94)90047-7"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.33","doi-asserted-by":"crossref","first-page":"G1059","DOI":"10.1152\/ajpgi.2000.279.5.G1059","article-title":"Human esophageal smooth muscle cells express muscarinic receptor subtypes M(1) through M(5)","volume":"279","author":"Wang","year":"2000","journal-title":"Am J Physiol Gastrointest Liver Physiol"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.34","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/S1052-3359(25)00678-7","article-title":"Neuronal control of esophageal function","volume":"5","author":"Richards","year":"1995","journal-title":"Chest Surg Clin N Am"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.encep.2011.07.002"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.36","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-006-9032-9"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.37","doi-asserted-by":"publisher","DOI":"10.1080\/15622970802176495"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.38","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.49.5.450-a"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.39","first-page":"327","article-title":"Risperidone and dysphagia","volume":"52","author":"Varghese","year":"2006","journal-title":"J Postgrad Med"},{"key":"2025042703545327000_2016.aug19_1.bcr2016216445.40","first-page":"37","article-title":"Dysphagia due to olanzapine, an antipsychotic medication","volume":"24","author":"Sagar","year":"2005","journal-title":"Indian J Gastroenterol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2016-216445","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T10:45:27Z","timestamp":1749552327000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2016-216445"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8,19]]},"references-count":40,"alternative-id":["10.1136\/bcr-2016-216445"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2016-216445","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,8,19]]}}}