1.Clozapine-related Sudden Pericarditis in a Patient Taking Long Acting Aripiprazole and Valproate: A Case Report.
Domenico DE BERARDIS ; Michele FORNARO ; Laura ORSOLINI ; Luigi OLIVIERI ; Francesco NAPPI ; Gabriella RAPINI ; Federica VELLANTE ; Cosimo NAPOLETANO ; Nicola SERRONI ; Massimo DI GIANNANTONIO
Clinical Psychopharmacology and Neuroscience 2018;16(4):505-507
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.
Adult
;
Anxiety
;
Aripiprazole*
;
Clozapine
;
Diagnosis
;
Drug Monitoring
;
Early Diagnosis
;
Female
;
Humans
;
Indomethacin
;
Myocarditis
;
Panic
;
Pericarditis*
;
Polypharmacy
;
Psychotic Disorders
;
Valproic Acid*