Abstract
Clozapine is an atypical antipsychotic used for treatment resistant schizophrenia. Its potential to induce agranulocytosis is well known but it can also cause myocarditis. Clozapine is the only antipsychotic known to induce this side effect, typically early in the treatment, and literature is scarce on this condition. We are presenting a case report of a 21-year-old schizophrenic male who developed myocarditis within 3 weeks of starting on clozapine for his treatment resistant psychosis. We then aim to review some of the available literature and raise awareness among physicians as this condition can potentially be fatal if not detected early.
Highlights
We are presenting the case of a 21-year-old male with 2 years of ongoing psychotic symptoms not responsive to several trials of medication. He was started on clozapine and developed myocarditis on the 23rd day after initiation of treatment
We have presented the case of a 21-year-old male with treatment resistant schizophrenia, no prior cardiac history and normal baseline investigations, who developed myocarditis on the 23rd day post-clozapine initiation
Clozapine is uncommonly associated with myocarditis, which can be fatal
Summary
We are presenting the case of a 21-year-old male with 2 years of ongoing psychotic symptoms not responsive to several trials of medication. He was started on clozapine and developed myocarditis on the 23rd day after initiation of treatment. Little is known about the pathophysiology of clozapine-induced myocarditis, but the mechanism is postulated to be a type 1 hypersensitivity reaction [3]. This condition has a variety of presenting symptoms. The first case report of clozapine-induced myocarditis was published in 1980 [12]. We suggest an approach to diagnosis and monitoring, based on our review of literature
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