Clozapina e miocardiopatia. Una ricerca in un Servizio di Salute Mentale

Translated title of the contribution: Clozapine and cardiomyopathy. An investigation conducted in a Mental Health Service

S. Domenichetti, C. Rostagno, F. Pastorelli, G. F. Gensini

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives: Atypical antipshycotics (clozapine) are the drugs of choice for schizophrenic patients resistant to major neuroleptics. The widespread clinical use of modern antipsychotic drugs followed the demonstration of the clinical superiority and the lower incidence of neurologic side effects, in particular extrapyramidal symptoms, of clozapine over chlor promazine in refractory schizophrenia. Methods: Moreover the treatment with clozapine has been demonstrated to be associated with a significant decrease in the risk of suicide. Despite its powerful clinical effects, however, clozapine treatment is associated with a not negligible risk of serious adverse effects, in particular, severe leucopenia to agranulocytosis, dilated cardiomyopathy, myocarditis, pericarditis and, rarely, sudden death. Severe cardiovascular side effects associated with clozapine treatment were initially the object of sporadic case reports, but after a post-marketing surveillance report from the drug manufacturer, careful monitoring for potentially fatal, although uncommon, myocarditis and cardiomyopathy was suggested. Moreover, several cases have been reported from large clinical data-bases. It must be underlined that the diagnosis of cardiac toxicity was usually made only when marked depression of left ventricular function and severe clinical symptoms occurred. Results: At present, no clinical investigation has assessed the potential sub clinical cardiac toxicity of clozapine. In the last five years we followed more than 60 psychotic patients without history of heart disease, aged less than 50 years, in chronic treatment with clozapine referred from the Florence Psychiatry Department. Conclusions: Three young males suffering from long-standing psychiatric disorders developed severe left ventricular dysfunction in absence of other significant risk factors other than long-term clozapine treatment.

Original languageItalian
Pages (from-to)286-298
Number of pages13
JournalItalian Journal of Psychopathology
Volume16
Issue number3
Publication statusPublished - Sep 2010

Fingerprint

Clozapine
Mental Health Services
Cardiomyopathies
Myocarditis
Antipsychotic Agents
Psychiatry
Promazine
Therapeutics
Agranulocytosis
Pericarditis
Leukopenia
Dilated Cardiomyopathy
Left Ventricular Dysfunction
Sudden Death
Marketing
Left Ventricular Function
Pharmaceutical Preparations
Suicide
Nervous System
Heart Diseases

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Domenichetti, S., Rostagno, C., Pastorelli, F., & Gensini, G. F. (2010). Clozapina e miocardiopatia. Una ricerca in un Servizio di Salute Mentale. Italian Journal of Psychopathology, 16(3), 286-298.

Clozapina e miocardiopatia. Una ricerca in un Servizio di Salute Mentale. / Domenichetti, S.; Rostagno, C.; Pastorelli, F.; Gensini, G. F.

In: Italian Journal of Psychopathology, Vol. 16, No. 3, 09.2010, p. 286-298.

Research output: Contribution to journalArticle

Domenichetti, S, Rostagno, C, Pastorelli, F & Gensini, GF 2010, 'Clozapina e miocardiopatia. Una ricerca in un Servizio di Salute Mentale', Italian Journal of Psychopathology, vol. 16, no. 3, pp. 286-298.
Domenichetti S, Rostagno C, Pastorelli F, Gensini GF. Clozapina e miocardiopatia. Una ricerca in un Servizio di Salute Mentale. Italian Journal of Psychopathology. 2010 Sep;16(3):286-298.
Domenichetti, S. ; Rostagno, C. ; Pastorelli, F. ; Gensini, G. F. / Clozapina e miocardiopatia. Una ricerca in un Servizio di Salute Mentale. In: Italian Journal of Psychopathology. 2010 ; Vol. 16, No. 3. pp. 286-298.
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