ArticleCanadian journal of psychiatry. Revue canadienne de psychiatrie2019
Incidence and Management of Clozapine-Induced Myocarditis in a Large Tertiary Hospital.
Article in Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 41 citations in OpenAlex.
- Clozapine-induced Myocarditis in Korea: Analysis of a Nationwide Database and Comparison to Other Countries.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2026Article
- Treating hearts and minds: adverse cardiovascular effects of psychiatric medications.Therapeutic advances in drug safety · 2026Review
- Diagnostic algorithm for clozapine-induced myocarditis: A systematic review.World journal of psychiatry · 2025Article
- A Case Report of Clozapine-Induced Cardiomyopathy.Cureus · 2025Article
- Review
- Development and validation of a risk model for intracardiac thrombosis in patients with dilated cardiomyopathy: a retrospective study.Scientific reports · 2024Article
- Serious adverse drug events associated with psychotropic treatment of bipolar or schizoaffective disorder: a 17-year follow-up on the LiSIE retrospective cohort study.Frontiers in psychiatry · 2024Article
- Clozapine-induced myocarditis and subsequent rechallenge: a narrative literature review and case report.Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent · 2023Article
- Reflections on the Lack of Consideration of Ethnic Ancestry to Stratify Clozapine Dosing.Psychiatry investigation · 2023Article
- Myocarditis in patients on long-term antipsychotics -mechanism, management and recent updates.Heliyon · 2023Review
- Seventy Years of Antipsychotic Development: A Critical Review.Biomedicines · 2023Review
- Second to none: rationale, timing, and clinical management of clozapine use in schizophrenia.Therapeutic advances in psychopharmacology · 2023Review
- A Slow, Cautious, and Successful Clozapine Rechallenge After Myocarditis.The primary care companion for CNS disorders · 2022Article
- An international guideline with six personalised titration schedules for preventing myocarditis and pneumonia associated with clozapine.General psychiatry · 2022Article
- Comparative Safety Signal Assessment of Hospitalization Associated With the Use of Atypical Antipsychotics.Frontiers in psychiatry · 2022Article
- A 25-Year-Old Man with Refractory Schizophrenia and Clozapine-Induced Myocarditis Diagnosed by Non-Invasive Cardiovascular Magnetic Resonance.The American journal of case reports · 2021Article
- Isolated nausea and vomiting as the cardinal presenting symptoms of clozapine-induced myocarditis: a case report.BMC psychiatry · 2020Article
- Protocol for Clozapine Rechallenge in a Case of Clozapine-Induced Myocarditis.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2020Article
- A Rational Use of Clozapine Based on Adverse Drug Reactions, Pharmacokinetics, and Clinical Pharmacopsychology.Psychotherapy and psychosomatics · 2020Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveClozapine, an antipsychotic reserved for management of treatment-resistant schizophrenia, is associated with severe adverse effects, including myocarditis. This study aims to determine the incidence of clozapine-induced myocarditis at a large tertiary hospital compared to what is reported in the literature.
methodsMedical records of adult patients admitted to psychiatry units receiving clozapine between January 1, 2010, and July 31, 2016, were retrospectively reviewed. Cases of clozapine-induced myocarditis were defined as having elevated C-reactive protein (CRP) or detectable troponin and at least 1 sign or symptom of myocarditis, in the absence of alternative plausible aetiologies. The primary outcome was incidence of clozapine-induced myocarditis during the study period. Secondary outcomes included rate and description of the management of clozapine-induced myocarditis.
resultsIn total, 316 patients were screened; 10 patients met the case definition for clozapine-induced myocarditis. The incidence of this adverse drug reaction over the study period was 3.16%. Reduced left ventricular ejection fraction was observed in 60% of cases, and electrocardiography changes were noted in 60% of cases. Clozapine was discontinued in all cases. Rechallenge was performed in 2 patients; recurrent CRP elevation resulted in discontinuation in each case. Medications for management of myocarditis were used in 50% of cases. Although 2 patients required transfer to critical care, the in-hospital mortality rate was 0%.
conclusionsThe incidence of clozapine-induced myocarditis at the study hospital was consistent with the higher range reported in the literature. Further research is necessary to elucidate risk factors, definitive diagnostic criteria, and effective management of clozapine-induced myocarditis.
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