Key result
Adding verapamil resolves rapid-onset clozapine-induced SVT in a young female patient.
Why the study?
Clozapine use is limited by serious cardiovascular adverse effects such as tachycardia, which usually occurs at higher dosages during early treatment stages.
Does verapamil allow for clozapine re-challenge in a patient who developed rapid-onset supraventricular tachycardia following clozapine initiation?
Case Report (n=1)
No
Does verapamil allow for clozapine re-challenge in a patient who developed rapid-onset supraventricular tachycardia following clozapine initiation?
Verapamil may be a useful pharmacological strategy to manage rapid-onset supraventricular tachycardia induced by clozapine, potentially allowing for continued treatment in patients with treatment-resistant schizophrenia.
Verapamil may facilitate clozapine continuation after SVT; hypothesis-generating and requires prospective validation.
Clozapine is the drug of choice for treatment-resistant schizophrenia. However, the use of clozapine is limited by its serious adverse effects, which often underlie its discontinuation. The cardiovascular side effects that raise safety concerns include tachycardia, myocarditis and cardiomyopathy. The development of clozapine-induced tachycardia is usually observed on higher dosage especially at early stages of treatment. Here, author presented the case of a patient with treatment-resistant schizophrenia who developed asymptotic supraventricular tachycardia despite low dose of clozapine at the second day of treatment. Additionally, author explored the possibility of clozapine re-challenge in combination with verapamil treatment.
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Afnan Alwabili (2019) conducted a case report in Treatment-resistant schizophrenia (n=1). Clozapine and Verapamil was evaluated on Management of clozapine-induced supraventricular tachycardia. A 29-year-old female with treatment-resistant schizophrenia developed rapid-onset supraventricular tachycardia on a low dose of clozapine, which was successfully managed by adding verapamil.
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