case_images: PMC11089194_01
case_images: Hepatic metabolism of clozapine: pharmacological active compounds are colored dark orange, inactive compounds light orange, and toxic compounds red.
case_images: fpsyt-15-1397876-g001.jpg
case_images: PMC11089194_01_fpsyt-15-1397876-g001.jpg
case_images: f1
case_images: Clozapine undergoes extensive hepatic metabolism ( Figure 1 ), with the major pathways being demethylation to N-desmethylclozapine (an active metabolite) and oxidation to clozapine N-oxide.
case_images: Summary of medical history from August 2020 to September 2022.
case_images: fpsyt-15-1397876-g002.jpg
case_images: PMC11089194_01_fpsyt-15-1397876-g002.jpg
case_images: f2
case_images: An altered clozapine metabolism was only detected when clozapine was combined with fluvoxamine, a potent inhibitor of CYP1A2 known to influence clozapine metabolism (August-October 2020, see  Figure 2 ;  Table 2 ).