Clozapine 為第二代非典型抗精神病藥物，主要用在治療其他藥物治療失效的精神分裂症與降低精神分裂症或情感性分裂症的復發性自殺行為。臨床上常見副作用包括有唾液增加、眩暈、嗜睡、心跳過快等；嚴重副作用包括有顆粒性白血球減少症(agranulocytosis)、癲癇、心肌炎等，此外，亦有報告指出clozapine 會引起發燒與罕見且可能致命的多發性漿膜炎 (polyserositis)。本文探討一位患有躁鬱症的48 歲女性，服用clozapine 後出現肋膜積液、腹水、心包積液及持續發燒的現象，排除感染及其他疾病之因素後，懷疑是clozapine 引起的多發性漿膜炎與發燒，經停藥後不良反應症狀逐漸改善並於一週內緩解。此屬極罕見之不良反應，醫護人員在臨床上使用clozapine 時須密切監測藥物相關不良反應。

　　Clozapine is a second generation (atypical) antipsychotics, it’s mainly used to treat patients with schizophrenia who failed to respond adequately to other antipsychotic treatment and reduce the risk of re-experiencing suicidal behavior in patients with schizophrenia or schizoaffective disorder. The common adverse effects of clozapine include sialorrhea, dizziness, drowsiness and tachycardia. Clozapine has also been associated with serious adverse events, including agranulocytosis, seizure and myocarditis. In addition, clozapine is reported to induce fever and inflammatory. syndromes with polyserositis, which is a rare but potentially life-threatening complication. This is a case of a 48-year-old female patient with bipolar disease who developed pleural effusion, ascites, pericardial effusion and continuously fever after clozapine use. Clozapine-induced polyserositis and fever was suspected after ruling out infection and other diseases. With the cessation of clozapine, her symptoms gradually improved and resolved within a week. This is a very rare adverse drug reaction of clozapine. It’s necessary for medical staff to closely monitor the drug related adverse reactions in clinical practice.