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KMID : 1009020180160040505
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Clinical Psychopharmacology and Neuroscience
2018 Volume.16 No. 4 p.505 ~ p.507
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Clozapine-related Sudden Pericarditis in a Patient Taking Long Acting Aripiprazole and Valproate: A Case Report
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De Berardis Domenico
Fornaro Michele
Orsolini Laura
Olivieri Luigi
Nappi Francesco
Rapini Gabriella
Vellante Federica
Napoletano Cosimo
Serroni Nicola
Di Giannantonio Massimo
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Abstract
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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.
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KEYWORD
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Clozapine, Pericarditis, Valproic acid, Polypharmacy, Drug monitoring
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