Why the study?
Following clozapine-associated myocarditis, clinicians face a challenging dilemma balancing risks of recurrent myocarditis against the harms of ongoing psychosis.
Cautious, slow rechallenge with clozapine can be safe and successful in patients who previously developed clozapine-associated myocarditis, offering a viable option for treatment-resistant psychiatric conditions.
May support cautious clozapine rechallenge after CAM in select cases; leaves open need for prospective safety data.
Clozapine is a highly effective medication used in management of treatment-resistant schizophrenia. Clozapine-associated myocarditis (CAM) is a rare but increasingly recognised complication of clozapine titration. Following an episode of CAM, clinicians can face a challenging dilemma of balancing the risks of recurrent myocarditis against the harms of ongoing psychosis. We describe the case of a woman in her 60s who developed acute myocarditis during clozapine titration and was then cautiously rechallenged with a successful outcome.
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Holden et al. (2022) studied this question.
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