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Published on: February 17, 2018
Severe tachycardia following low-dose clozapine treatment
Hans Stampfer1, Peter Swanepoel
1University Department of Psychiatry and Behavioural Science, QEII Medical Centre, Nedlands, WA, Australia. hgstamp@cyllene.uwa.edu.au
Objective:
To report a case of severe and sustained tachycardia that developed asymptomatically on a low dose of clozapine (150 mg daily).
Method:
Case report.
Results:
Serially monitored 24 h heart rate after the introduction of clozapine showed an increase in the 24 h mean from 87 to 126 bpm, a reduction of pulse variability and anomalies in sleep-wake regulation. Cessation of clozapine was followed by a rapid return to preclozapine activity. Application of the Naranjo Adverse Drug Reaction Probability Scale indicated a probable relationship between clozapine and the sustained tachycardia.
Conclusions:
Severe and sustained tachycardia can develop asymptomatically with a relatively low dose of clozapine and a slow titration rate. The severity of the tachycardia may not be revealed in isolated pulse measurements and may escape clinical detection without closer monitoring of heart rate.
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