Esophageal dysfunction on psychotropic medication. A case report and literature review

Pharmacopsychiatry. 2004 May;37(3):134-8. doi: 10.1055/s-2004-818993.


We report the association of long-term clozapine and clomipramine therapy with severe esophageal dilation and hypomotility in a patient with chronic schizophrenia leading to life threatening aspiration pneumonia. Severe aspiration pneumonia manifested suddenly and required intubation and intensive care. Gross impairment of swallowing function with esophageal dilation and hypomotility was detected on videofluoroscopy and manometry. The patient recovered well following a reduction in the dose of clozapine and the withdrawal of clomipramine. The restoration of esophageal function was documented by manometry. The reported side effects and possible pharmacological actions of clozapine, an atypical neuroleptic, and clomipramine, a tricyclic antidepressant, on esophageal motility are discussed.

Publication types

  • Case Reports
  • Comparative Study
  • Review

MeSH terms

  • Esophageal Diseases / chemically induced*
  • Esophageal Diseases / pathology
  • Humans
  • Male
  • Manometry / methods
  • Middle Aged
  • Psychotropic Drugs / adverse effects*
  • Psychotropic Drugs / therapeutic use
  • Retrospective Studies
  • Schizophrenia / complications*
  • Schizophrenia / drug therapy
  • Schizophrenia / pathology
  • Thorax / pathology
  • Tomography, X-Ray Computed / methods


  • Psychotropic Drugs