Clozapine-related Sudden Pericarditis in a Patient Taking Long Acting Aripiprazole and Valproate: A Case Report.
10.9758/cpn.2018.16.4.505
- Author:
Domenico DE BERARDIS
1
;
Michele FORNARO
;
Laura ORSOLINI
;
Luigi OLIVIERI
;
Francesco NAPPI
;
Gabriella RAPINI
;
Federica VELLANTE
;
Cosimo NAPOLETANO
;
Nicola SERRONI
;
Massimo DI GIANNANTONIO
Author Information
1. National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “G. Mazzini”, Teramo, Italy. domenico.deberardis@aslteramo.it
- Publication Type:Case Report
- Keywords:
Clozapine;
Pericarditis;
Valproic acid;
Polypharmacy;
Drug monitoring
- MeSH:
Adult;
Anxiety;
Aripiprazole*;
Clozapine;
Diagnosis;
Drug Monitoring;
Early Diagnosis;
Female;
Humans;
Indomethacin;
Myocarditis;
Panic;
Pericarditis*;
Polypharmacy;
Psychotic Disorders;
Valproic Acid*
- From:Clinical Psychopharmacology and Neuroscience
2018;16(4):505-507
- CountryRepublic of Korea
- Language:English
-
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.
