Atypical antipsychotics: Clozapine‐related cardiac complications

Abstract:

We read with interest the review by Friedman and Factor1 about the use of atypical antipsychotics to treat the psychosis induced by L-dopa in patients with Parkinson’s disease. When they discuss clozapine, they mention a patient who developed a possible myocardial infarction (Parkinson’s Study Group, reference 27), 2 another death resulting from an unknown cause, and three more deaths caused by cardiac-related problems (reference 29). 3 I would like to draw attention to an article by Kilian et al. 4 in which 23 cardiac disease cases were reported (15 of them developed myocarditis and eight of them cardiomyopathy) related to the use of clozapine. Six of them died: five because of myocarditis that happened in the first 3 weeks of clozapine treatment, and the last one caused by cardiomyopathy diagnosed 36 months after beginning clozapine. Among the people who died, two of them were found in their beds (reported case nos. 1 and 2). All six who died underwent an autopsy. Even though the doses that were used in these patients with schizophrenia were high (from 100 to 775 mg per day in the 23 patients with cardiac pathology related to clozapine), and schizophrenics have an increased incidence of sudden death, the mean age of these 23 patients was 36 years. 4 On the other hand, the mean age of the patients studied by the Parkinson’s Study Group was 70.8 years old and mean dosage was 27 mg per day. 2

Año de publicación:

2000

Keywords:

Fuente:

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