Title:Update on the Adverse Effects of Clozapine: Focus on Myocarditis
Volume: 7
Issue: 1
Author(s): Domenico De Berardis, Nicola Serroni, Daniela Campanella, Luigi Olivieri, Francesca Ferri, Alessandro Carano, Marilde Cavuto, Giovanni Martinotti, Alessandra Cicconetti, Monica Piersanti, Francesco Saverio Moschetta and Massimo Di Giannantonio
Affiliation:
Keywords:
Clozapine, myocarditis, cardiomyopathy schizophrenia, heart failure
Abstract: Clozapine, an atypical antipsychotic, is a dibenzodiazepine derivative and its therapeutic effects are probably
mediated by dopaminergic and serotonergic activity. In accordance to several studies, it appears to be the most effective
antipsychotic drug for treatment-resistant schizophrenia. Moreover, clozapine appears to be particularly beneficial in
patients with schizophrenia who are suicidal and in those with comorbid substance use disorder. However, despite its
efficacy, the general use of clozapine in clinical practice is somewhat limited because of the risk of several serious adverse
effects such as agranulocytosis and thromboembolism. Clozapine may be associated with fatal myocarditis and
cardiomyopathy in physically healthy young adults. Consequently, the FDA and the drug's manufacturer have
strengthened warnings to include that a potentially fatal myocarditis may occur when taking clozapine. In the present
paper the literature on clozapine-related myocardis will be reviewed and practical advice will be given concerning the
diagnosis and management of such potentially fatal adverse effect.
