Resolution without discontinuation: heart failure during clozapine treatment
Eromona Whiskey1, Shirley Yuen2, Emma Khosla3
1Pharmacy department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK.
Therapeutic Advances in Psychopharmacology
|June 18, 2020
Summary
This case study explores continuing clozapine treatment despite heart failure in a patient with treatment-resistant schizoaffective disorder. The patient
Area of Science:
- Psychiatry
- Cardiology
- Pharmacology
Background:
- Clozapine is a vital antipsychotic for treatment-resistant schizophrenia but is often discontinued due to adverse effects.
- Clozapine-induced heart failure is a serious complication that typically leads to treatment cessation.
Observation:
- A 51-year-old man with treatment-resistant schizoaffective disorder underwent clozapine rechallenge.
- He developed heart failure within six months, likely due to clozapine.
- Despite the diagnosis, clozapine was continued with cardiology consultation and medical management.
Findings:
- The patient's cardiac condition improved with ramipril and bisoprolol, alongside continued clozapine.
- This case demonstrates a potential for managing clozapine-induced heart failure without immediate drug cessation.
Implications:
- Continued clozapine use in cardiac complication cases may be possible with careful monitoring and specialist input.
- Further research is needed to establish evidence-based guidelines for managing clozapine-induced cardiac issues.
- Balancing the benefits of clozapine in refractory psychosis against cardiac risks requires individualized treatment strategies.
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