clozapine and Tachycardia--Supraventricular

Clozapine is considered to be more effective than other antipsychotic drugs for treating treatmentresistant schizophrenia. However, side effects of clozapine include agranulocytosis and, less commonly, cardiovascular disease, which is occasionally fatal. We describe a 56-year-old woman who developed clozapine-related paroxysmal supraventricular tachycardia during clozapine dose titration and had a recurrence despite being treated with verapamil. For treatment-resistant schizophrenia, a slow titration of the clozapine dose is necessary, and potential cardiac side-effects should be monitored.

Topics: Anti-Arrhythmia Agents; Antipsychotic Agents; Clozapine; Female; Humans; Middle Aged; Recurrence; Tachycardia, Paroxysmal; Tachycardia, Supraventricular; Verapamil

Topics: Adult; Antipsychotic Agents; Clozapine; Dose-Response Relationship, Drug; Female; Humans; Schizophrenia; Tachycardia, Supraventricular

A patient receiving electroconvulsive therapy (ECT), clozapine, and intravenous caffeine sodium benzoate developed supraventricular tachycardia. This was rapidly treated with intravenous verapamil. Subsequent maintenance ECT given without caffeine was well tolerated. We believe the combination of clozapine and caffeine at the time of ECT was responsible for the arrhythmia.

Topics: Affective Disorders, Psychotic; Aged; Caffeine; Clozapine; Combined Modality Therapy; Depressive Disorder; Drug Therapy, Combination; Electrocardiography; Electroconvulsive Therapy; Female; Humans; Recurrence; Tachycardia, Supraventricular