Clozapine-induced myocarditis and patient outcomes after drug rechallenge following myocarditis: A systematic case review

  title={Clozapine-induced myocarditis and patient outcomes after drug rechallenge following myocarditis: A systematic case review},
  author={Naomi D Richardson and Steven C. Greenway and Chad A. Bousman},
  journal={Psychiatry Research},
Clozapine is underutilized due, in part, to concerns about rare but severe adverse drug reactions, including cardiac inflammation and injury (myocarditis). Risk factors for clozapine induced myocarditis are limited and predictors for the successful rechallenge of clozapine after an episode of myocarditis are even more poorly understood. We conducted a systematic review, in accordance with the PRISMA recommendation, of published case reports to describe demographic and clinical characteristics… 
4 Citations

Clozapine-induced myocarditis: signs and symptoms

  • Medicine, Psychology
    Reactions Weekly
  • 2021
The need for standardized reporting of these clinical experiences to enable the assembly of a comprehensive clinical picture of this severe adverse drug reaction and the clinical factors robustly associated with rechallenge success are highlighted.

Monitoring Patients With Psychotic Disorders for Clozapine-Induced Myocarditis or Cardiomyopathy

Three evidence-based guidelines were identified about the use of clozapine for patients with psychotic disorders and several of the recommendations were derived from sources of evidence that may not be considered of the highest quality, with the strength of recommendation not reported and unclear.

Safer use of clozapine

  • D. Taylor
  • Psychology, Medicine
    Acta psychiatrica Scandinavica
  • 2022
This is, perhaps, the most comprehensive review of clozapinerelated side effects ever published, and an erudite synthesis of a huge volume of data containing many evidencedbased observations and recommendations.

Mapping the Knowledge of Antipsychotics-Induced Sudden Cardiac Death: A Scientometric Analysis in CiteSpace and VOSviewer

This study showed that a research hotspot is that the mechanisms of cardiotoxicity, the safety monitoring, and the assessment of the risk-benefit during clinical use of some newer antipsychotics, clozapine and olanzapine, are shown.



Protocol for Clozapine Rechallenge in a Case of Clozapine-Induced Myocarditis

A successful clozapine rechallenge protocol is developed, based on careful monitoring of changes in these indices and a very slow clozabine re-titration, which may have utility in the management of patients with a history of clozAPine-induced myocarditis.

Clozapine-induced myocarditis: Separating the wheat from the chaff

The veracity of the diagnoses of clozapine-induced myocarditis may be suboptimal because appropriate clinical investigations to clarify and confirm the diagnosis were not done, or not recorded in clinical notes.

Clozapine-Related Myocarditis and Cardiomyopathy in an Australian Metropolitan Psychiatric Service

There was an apparent high incidence of clozapine-related myocarditis within this service, for which there was no clear reason, and the clinician’s role in post-marketing drug surveillance to guide rational management of suspected adverse drug effects was highlighted.

Clozapine-Associated Myocarditis

Clozapine is uncommonly but importantly related to myocarditis, often fatal or near fatal and sometimes in relatively young patients with early onset after treatment initiation, and a case-control study would be suitable for investigation of baseline predictors.

Diagnostic characteristics of clozapine-induced myocarditis identified by an analysis of 38 cases and 47 controls.

Eosinophil counts should not be relied on for diagnosis of clozapine-relatedMyocarditis, but elevated CRP may be an early indicator of developing myocarditis.

A New Monitoring Protocol for Clozapine-Induced Myocarditis Based on an Analysis of 75 Cases and 94 Controls

This protocol recommends active monitoring for 4 weeks, relying predominantly on troponin and C-reactive protein results, and encourages continuation of clozapine in the presence of mild illness, but defines a threshold for cessation.

Successful Clozapine Rechallenge After Suspected Clozapine-Associated Myocarditis: A Case Report.

C lozapine has demonstrated superiority among antipsychotic medications and is the only approved drug for the management of treatment refractory schizophrenia, and clozapine rechallenge has been cautiously explored and attempted with a success rate among patients.

Clozapine‐induced myocarditis, a widely overlooked adverse reaction

The published cases of clozapine‐induced myocarditis are reviewed and reasons for the higher incidence in Australia than elsewhere are described.