Does A subclinical cardiotoxic effect of clozapine exist? Results from a follow-up pilot study

Carlo Rostagno, Sandro Domenichetti, Gian Franco Gensini

Research output: Contribution to journalArticlepeer-review


Aim: The aim of the present study was to investigate by serial echocardiography and dosage of NT-pro-BNP, whether, in previously healthy subjects, long term therapy with clozapine may lead to subclinical cardiac toxicity. Methods and Results: 38 patients (24 males, 14 females, mean age 38.4 years) suffering from a severe personality disorder were enrolled. At inclusion duration of clozapine treatment averaged 66 months at a mean daily dose of 296 mg. Clinical evaluation, NT-pro-BNP dosage and echocardiography were performed at baseline, 3 and 12 months. At first visit 15 patients showed depression of left ventricular function (12 had LVEF between 50 and 55%, 22= -0.4619, p 5% was found in 33% of patients with baseline normal LVEF while LVEF remained below 55% in 70% of group B patients. LVEF and NT-pro-BNP values were still significantly different in the two groups at the term of follow-up. Conclusions: subclinical heart dysfunction, frequently biventricular, occurs in 1/3 of young, previously healthy, clozapine treated patients. NT-pro-BNP values relate inversely with LVEF. At 1 year follow -up a LVEF decrease >5% occurred in 1/3 of patients with baseline normal left ventricular function.

Original languageEnglish
Pages (from-to)148-153
Number of pages6
JournalCardiovascular and Hematological Agents in Medicinal Chemistry
Issue number2
Publication statusPublished - Jun 2012


  • Adverse effects
  • Cardiomyopathy
  • Clozapine
  • Diastolic function
  • Echocardiography
  • Metabolic syndrome
  • NT-pro-BNP
  • QT i nterval
  • Refractory schizophrenia
  • Right ventricular function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Hematology
  • Pharmacology


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