TY - JOUR
T1 - Clozapine-Associated Myocarditis
T2 - A Protocol for Monitoring Upon Clozapine Initiation and Recommendations for How to Conduct a Clozapine Rechallenge
AU - Griffin, Jan M.
AU - Woznica, Edgar
AU - Gilotra, Nisha A.
AU - Nucifora, Frederick C.
N1 - Publisher Copyright:
© 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Background: Clozapine is the only medication with Food and Drug Administration approval for treatment-resistant schizophrenia. However, it is underutilized in the United States because of several life-threatening adverse effects, including clozapine-associated myocarditis (CAM), and a limited understanding of how to manage these complications. To date, recommendations for rechallenging patients with CAM that incorporate the cardiac literature or cardioprotective medications have not been developed. Findings In this article, we outline a protocol developed with cardiologists and guided by the cardiac literature that provides direction on how to monitor for the initial development of CAM and how to rechallenge patients with CAM. Furthermore, we present 2 successful cases of clozapine rechallenge that were managed using this protocol. Conclusions: In both cases, the patients showed marked improvement in their psychiatric symptoms and functioning, demonstrating the importance of considering rechallenge in patients after CAM.
AB - Background: Clozapine is the only medication with Food and Drug Administration approval for treatment-resistant schizophrenia. However, it is underutilized in the United States because of several life-threatening adverse effects, including clozapine-associated myocarditis (CAM), and a limited understanding of how to manage these complications. To date, recommendations for rechallenging patients with CAM that incorporate the cardiac literature or cardioprotective medications have not been developed. Findings In this article, we outline a protocol developed with cardiologists and guided by the cardiac literature that provides direction on how to monitor for the initial development of CAM and how to rechallenge patients with CAM. Furthermore, we present 2 successful cases of clozapine rechallenge that were managed using this protocol. Conclusions: In both cases, the patients showed marked improvement in their psychiatric symptoms and functioning, demonstrating the importance of considering rechallenge in patients after CAM.
KW - clozapine
KW - myocarditis
KW - rechallenge
KW - schizophrenia
KW - treatment-resistant schizophrenia
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U2 - 10.1097/JCP.0000000000001358
DO - 10.1097/JCP.0000000000001358
M3 - Article
C2 - 33587399
AN - SCOPUS:85102607957
SN - 0271-0749
VL - 41
SP - 180
EP - 185
JO - Journal of clinical psychopharmacology
JF - Journal of clinical psychopharmacology
IS - 2
ER -