Clozapine and sudden death

Devarajan, S.; Kutcher, Stan; Dursun, S.M.

doi:10.1016/s0140-6736(00)00035-0

Cited by 41 publications

(28 citation statements)

References 5 publications

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“…So far, looking into clozapine catabolism in Australian subpopulations has not confirmed genetic differences hypothesis [3, 18]. There have been recent genetic studies on genetic susceptibility to myocarditis, but of the autoimmune variety only [19, 20].…”

Section: Discussionmentioning

confidence: 99%

Clozapine-Induced Myocarditis: Is Mandatory Monitoring Warranted for Its Early Recognition?

Munshi

Volochniouk

Hassan

et al. 2014

Case Reports in Psychiatry

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Clozapine is an atypical antipsychotic used for treatment resistant schizophrenia. Its potential to induce agranulocytosis is well known but it can also cause myocarditis. Clozapine is the only antipsychotic known to induce this side effect, typically early in the treatment, and literature is scarce on this condition. We are presenting a case report of a 21-year-old schizophrenic male who developed myocarditis within 3 weeks of starting on clozapine for his treatment resistant psychosis. We then aim to review some of the available literature and raise awareness among physicians as this condition can potentially be fatal if not detected early.

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Section: Discussionmentioning

confidence: 99%

Clozapine-Induced Myocarditis: Is Mandatory Monitoring Warranted for Its Early Recognition?

Munshi

Volochniouk

Hassan

et al. 2014

Case Reports in Psychiatry

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“…These mechanisms include: (1) an underlying deficiency of hepatic enzymes (CYP 450 to 1A2 and CYP 450 to 1A3), thereby increasing clozapine concentrations; (2) cardiotoxic effects of eosinophilic-mediated blockage of cholinergic M2 receptors; and/or (3) atmospheric ozone levels incurring dysfunctional cholinergic receptors. 17,18 Promising early studies suggest the lack of antioxidative protection secondary to a low level of selenium in schizophrenics as an explanation for clozapine associated cardiomyopathy. 19 The first documented …”

Section: Discussionmentioning

confidence: 99%

Masked Clozapine-induced Cardiomyopathy

Pastor¹,

Mehta²

2008

The Journal of the American Board of Family Medicine

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A 33-year-old Latin-American woman with a history of psychosis and mood disorder, but no cardiac history or risk factors, presented with heart failure after 6 weeks of clozapine and olanzapine therapy. Her presentation was ambiguous and further complicated by a highly suggestible nature, which delayed the proper diagnosis and treatment. After discontinuing the antipsychotic agents and completing an otherwise negative comprehensive work-up, her heart function significantly improved (left ventricular ejection fraction increased from 38% to 53%). A literature search showed that cardiomyopathy secondary to antipsychotics has been reported but remains poorly understood. This is the second documented case report of clozapine-induced cardiomyopathy in a Latin-American woman. (

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“…Devarajan et al (49) have discussed possible mechanisms to explain clozapine‐related cardiac side‐effects such as myocarditis and cardiomyopathy. They suggest that a lack of metabolic enzymes (CYP450‐1A2 and CYP450‐1A3) resulting in extreme clozapine concentrations, direct cardiotoxic effects of eosinophils through blockage of cholinergic M 2 ‐receptors or high concentrations of atmospheric ozone resulting in cholinergic receptor dysfunction, may have played a role.…”

Section: Discussionmentioning

confidence: 99%