Why the study?
Recommendations for rechallenging patients with clozapine-associated myocarditis that incorporate the cardiac literature or cardioprotective medications have not been developed.
Does a structured monitoring protocol allow for safe clozapine rechallenge in patients with prior clozapine-associated myocarditis?
Does a structured monitoring protocol allow for safe clozapine rechallenge in patients with prior clozapine-associated myocarditis?
A structured monitoring protocol developed with cardiologists may allow for safe clozapine rechallenge in patients who previously developed clozapine-associated myocarditis.
May inform cautious clozapine rechallenge protocols after CAM; leaves open need for prospective validation.
BACKGROUND: Clozapine is the only medication with Food and Drug Administration approval for treatment-resistant schizophrenia. However, it is underutilized in the United States because of several life-threatening adverse effects, including clozapine-associated myocarditis (CAM), and a limited understanding of how to manage these complications. To date, recommendations for rechallenging patients with CAM that incorporate the cardiac literature or cardioprotective medications have not been developed. FINDINGS: In this article, we outline a protocol developed with cardiologists and guided by the cardiac literature that provides direction on how to monitor for the initial development of CAM and how to rechallenge patients with CAM. Furthermore, we present 2 successful cases of clozapine rechallenge that were managed using this protocol. CONCLUSIONS: In both cases, the patients showed marked improvement in their psychiatric symptoms and functioning, demonstrating the importance of considering rechallenge in patients after CAM.
No takes yet. Share an insight, caveat, or question.
Griffin et al. (2021) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: