Clin Psychopharmacol Neurosci.
2018 Nov;16(4):505-507. 10.9758/cpn.2018.16.4.505.
Clozapine-related Sudden Pericarditis in a Patient Taking Long Acting Aripiprazole and Valproate: A Case Report
- De Berardis D
- Fornaro M
- Orsolini L
- Olivieri L
- Nappi F
- Rapini G
- Vellante F
- Napoletano C
- Serroni N
- Di Giannantonio M
- Affiliations
-
- 1National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “G. Mazziniâ€, Teramo, Italy. domenico.deberardis@aslteramo.it
- 2Department of Neurosciences and Imaging, University “G. d’Annunzioâ€, Chieti, Italy.
- 3Polyedra Research Group, Teramo, Italy.
- 4New York Psychiatric Institute, Columbia University, New York, NY, USA.
- 5School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
- 6Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, The Netherlands.
- 7Department of Cardiovascular, Hospital “G. Mazziniâ€, Teramo, Italy.
- KMID: 2428982
- DOI: http://doi.org/10.9758/cpn.2018.16.4.505
Abstract
- Clozapine may be associated with cardiovascular adverse effects including QTc prolongation and, more rarely, with myocarditis and pericarditis. Although rare, these latter cardiovascular adverse effects may be life-threatening and must be immediately recognized and treated. Several cases of clozapine related-pericarditis have been described and often it has a subtle and insidious onset with symptoms that may be often misdiagnosed with psychiatric manifestations (e.g. anxiety, panic or somatization) leading to a delayed correct diagnosis with potential fatal consequences. In the present report we describe the case of a 27-year-old girl with schizoaffective disorder taking long acting aripiprazole and valproate who developed a sudden onset clozapine-related pericarditis during titration phase that resolved with immediate clozapine discontinuation and indomethacin administration. We underline the importance of an early diagnosis of clozapine-related pericarditis and the need to have monitoring protocols to prevent this potentially fatal adverse effect especially when polypharmacy is administered to patients taking clozapine.
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