Abstract
The Sri Lanka Journal of Psychiatry (SLJP) is a peer-reviewed, open access journal published bi annually by the Sri Lanka College of Psychiatrists.The Journal publishes original papers, brief reports including case reports and commentaries relevant to psychiatry and allied sciences. The Sri Lanka Journal of Psychiatry is committed to maintaining and conforming to the editorial and ethical standards recommended by the International Committee of Medical Journal Editors.Cover“Perseverance”. These tenacious fishermen in Mannar continue their livelihood despite numerous difficulties. L. N. P. Samarasinghe, Acting Consultant Psychiatrist, Base Hospital Nikaweratiya, Sri Lanka.
Highlights
Among patients diagnosed to have schizophrenia, about 30% are known to develop resistant schizophrenia, for which clozapine is currently considered the drug of choice (1)
We report a case of a patient who developed pericardial effusion while on clozapine treatment, which is considered as a rare side effect, with only a few published reports (2)
Orthostatic hypotension and tachycardia are reported as common side effects of clozapine, while cardiovascular adverse effects such as myocarditis, pericarditis and cardiomyopathy are documented, albeit less commonly (1)
Summary
Among patients diagnosed to have schizophrenia, about 30% are known to develop resistant schizophrenia, for which clozapine is currently considered the drug of choice (1). Treatment was commenced after an initial workup, which included full blood count, liver and renal function tests, C-reactive protein (CRP), electrocardiogram (ECG) and echocardiography, all of which were normal. She developed a fever spike (101.1 F) on the fourth day of clozapine while on a daily dose of 75 mg of clozapine. There were no systemic or other constitutional complaints and the physical examination was unremarkable, except for hyperthermia (101.1 F) and a tachycardia (104 b.p.m) Her total white cell count (WBC) was 14140/μl, with a neutrophil count and eosinophil count of 8730/μl and 1060/μl respectively.
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