Background:
Clozapine continues to have a unique efficacy profile that to date has not been matched or enhanced by other second-generation antipsychotics. Although agranulocytosis is a well-documented vulnerability for these patients, other serious risks, such as myocarditis and cardiomyopathy, are less well recognized and there remains a dearth of examination in this area. The current study aims to investigate changes in cardiac functioning in a group of patients treated for the first time with clozapine.
Methods:
Transthoracic echocardiograms were conducted on 77 clozapine-naïve patients, prior to commencing clozapine treatment (time 1) and were repeated after 6–12 months (time 2). Patient psychiatric and medication history were documented, as were full white blood count, troponin 1 and creatinine kinase results. The rate of clozapine titration was also recorded.
Results:
Preliminary analyses of the data set indicate a decrease in left ventricular shortening, a measure of ventricular contractility, from time 1 (pre clozapine) to time 2. Further analyses will be presented.
Conclusions:
Although there appears to be a trend toward a worsening of cardiac function with clozap-ine treatment, further investigations need to be carried out taking into account confounding factors that are known to be implicated in cardiac dysfunction. Establishing a clearer understanding of the link between the two will help patients and clinicians balance the risk of cardiac problems and improved psychopathology and help to institute cardiac monitoring guidelines for patients treated with clozapine.
