ReviewCNS drugs2017
Cardiovascular Disease in Clozapine-Treated Patients: Evidence, Mechanisms and Management.
Review in CNS drugs, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Evaluating Monitoring Guidelines of Clozapine-Induced Adverse Effects: a Systematic Review.CNS drugs · 2024Pooled it
- The Role of Sodium Valproate in Clozapine-Associated Cardiotoxicities: The Importance of Cellular and Systemic Energetics.Cardiovascular toxicology · 2026Review
- Clozapine impairs angiogenic function and cellular bioenergetics in primary human endothelial progenitor cells and zebrafish: involvement of aryl hydrocarbon receptor signaling.Archives of toxicology · 2026Article
- Metabolic syndrome severity and the effects of intensive blood pressure lowering: Results from the STEP randomized trial.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Clozapine acts as an antagonist of human dopamine DNaunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Clozapine-Associated Pulmonary Embolism: Continuation of Clozapine Therapy With Concurrent Anticoagulation.Case reports in psychiatry · 2026Article
- The adverse effects of clozapine on blood markers and electrocardiographic findings in patients with schizophrenia.BioMedicine · 2026Article
- Article
- Clozapine is a functional antagonist at cardiac human HNaunyn-Schmiedeberg's archives of pharmacology · 2025Article
- A Review of Clinical Advances and Challenges in Clozapine-Induced Myocarditis.Neuropsychiatric disease and treatment · 2025Review
- [Safety aspects during treatment with clozapine: : Adverse effects, titration, and therapeutic drug monitoring - a narrative review].Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater · 2023Review
- Clozapine-Related Thromboembolic Events.Cureus · 2021Review
- Lithium and Atypical Antipsychotics: The Possible WNT/β Pathway Target in Glaucoma.Biomedicines · 2021Review
- A Working Hypothesis Regarding Identical Pathomechanisms between Clinical Efficacy and Adverse Reaction of Clozapine via the Activation of Connexin43.International journal of molecular sciences · 2020Review
- Cardiovascular Adverse Reactions During Antipsychotic Treatment: Results of AMSP, A Drug Surveillance Program Between 1993 and 2013.The international journal of neuropsychopharmacology · 2020Observational
- The physical health and side-effect monitoring of patients prescribed clozapine: data from a clinical audit conducted in UK mental health services.Therapeutic advances in psychopharmacology · 2020Article
- A Rational Use of Clozapine Based on Adverse Drug Reactions, Pharmacokinetics, and Clinical Pharmacopsychology.Psychotherapy and psychosomatics · 2020Review
- Safety of antipsychotics for the treatment of schizophrenia: a focus on the adverse effects of clozapine.Therapeutic advances in drug safety · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Myocarditis occurs in about 3% of those initiated on clozapine but monitoring reduces the risk of serious outcome. Cardiomyopathy may develop after myocarditis, or from prolonged tachycardia. Monitoring using echocardiography is not deemed cost effective. Tachycardia, orthostatic hypotension and reduced heart rate variability are a group of clozapine-related adverse effects associated with autonomic dysfunction and may have serious consequences in the long term. Elevated heart rate and poor heart rate variability can be treated with a β-blocker or a non-dihydropyridine calcium channel blocker, while orthostatic hypotension can be alleviated by increased fluid intake and abdominal binding, but may require pharmacological intervention. Adequate correction for heart rate may show that clozapine does not prolong the QT interval. Other cardiovascular effects, pulmonary embolism, metabolic syndrome, sudden cardiac death and particularly the excessive mortality from cardiovascular disease events may be more strongly associated with the combination of mental illness, lifestyle factors and poor treatment of cardiovascular disease and its risk factors than with clozapine treatment. In view of the efficacy of clozapine and the evidence of reduced mortality relative to other antipsychotics, clozapine should be prescribed when indicated and recipients should be enrolled in lifestyle programmes to increase exercise and improve diet, and referred for diagnosis and treatment of cardiovascular disease and its risk factors.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.