Inflammatory response to clozapine in the absence of myocarditis: case report

A case is presented of a 25-year-old man with treatment-resistant paranoid schizophrenia whose only previous trial of clozapine had been stopped following a suspected clozapine-induced myocarditis. Due to the failure of his psychosis to respond to a number of antipsychotic treatments and augmentatio...

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Bibliographic Details
Main Authors: Patrick Davey, Siobhan Gee, Sukhi S. Shergill
Format: Article
Language:English
Published: Cambridge University Press 2016-05-01
Series:BJPsych Open
Online Access:https://www.cambridge.org/core/product/identifier/S2056472400001447/type/journal_article
Description
Summary:A case is presented of a 25-year-old man with treatment-resistant paranoid schizophrenia whose only previous trial of clozapine had been stopped following a suspected clozapine-induced myocarditis. Due to the failure of his psychosis to respond to a number of antipsychotic treatments and augmentation strategies, clozapine was restarted on admission. His rechallenge was marked by intermittent pyrexia, tachycardia and elevated C-reactive protein (CRP), but eosinophilia was absent. Clozapine was started and then stopped twice following extensive investigation and with specialist cardiology consultation. Physical symptoms and CRP elevation resolved shortly after clozapine cessation. We believe this constituted an idiosyncratic systemic inflammatory response to clozapine treatment.
ISSN:2056-4724