Lecture – Clozapine-Induced Myocarditis

Available with English captions.

Stephanie C. Valcourt, MD, McLean Hospital – McLean Forum lecture

Clozapine is a second-generation antipsychotic medication that is considered uniquely effective in the treatment of schizophrenia, particularly among patients whose symptoms have not responded to other medications.

Presentation highlights include:

  • Recognition of clozapine as one of the most effective treatment options for schizophrenia, with serious, though manageable, risks
  • Identification of the clinical features of clozapine-induced myocarditis, including signs/symptoms and course
  • Description of monitoring guidelines to detect clozapine-induced myocarditis using an evidence-based approach

Clozapine-induced myocarditis is a rare but serious side effect, occurring in approximately 1-3% of patients starting clozapine. Case detection rates of clozapine-induced myocarditis appear to be increasing, likely due to improved monitoring.

Guidelines for monitoring include close observation of vital signs and non-specific symptoms, review of at-least-weekly laboratory data, and completion of EKG/echocardiography studies, especially during the first four weeks of treatment.