Beta-blocker and angiotensin-converting enzyme inhibitor may limit certain cardiac adverse effects of clozapine

General Hospital Psychiatry
Carlo RostagnoGian Franco Gensini

Abstract

Clozapine is contraindicated in patients who experienced cardiac adverse effects during therapy. A young male (34 years old) with clozapine-responsive schizophrenia developed hypokinetic cardiomyopathy during treatment. The decision to resume clozapine therapy and to treat cardiac problems with carvedilol and captopril was made due to the failure of other antipsychotics to control symptoms. He was followed up for 5 years. Significant improvement of psychiatric conditions and persistence of normal left ventricular function were obtained with combination treatment. beta-Blockers and ACE inhibitors may allow resumption of clozapine in refractory schizophrenia in whom it was withdrawn for cardiotoxicity. A large-scale investigation may be useful to confirm the present observations.

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Citations

Oct 12, 2010·Internal and Emergency Medicine·Carlo RostagnoGian Franco Gensini
Dec 29, 2010·Journal of Child and Adolescent Psychopharmacology·Vanessa Toney BobbBarbara J Coffey
Jun 8, 2015·International Clinical Psychopharmacology·Martina CurtoRoss J Baldessarini
May 26, 2016·Current Psychiatry Reports·Martina CurtoRoss J Baldessarini
May 15, 2015·The Australian and New Zealand Journal of Psychiatry·Trino BaptistaDiego F Dávila
Oct 25, 2011·Journal of Clinical Psychopharmacology·Carlo RostagnoGian Franco Gensini
Jun 18, 2020·Therapeutic Advances in Psychopharmacology·Eromona WhiskeyDavid Taylor
Sep 2, 2021·Irish Journal of Psychological Medicine·F WilliamsA Rowe

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