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Continuing clozapine treatment after a diagnosis of cardiomyopathy

Published online by Cambridge University Press:  09 May 2018

F. Williams ,
F. Lenihan  and
A. Rowe
F. Williams*
Affiliation:
NHS Fife, Learning Disability Service, Lynebank Hospital, Dunfermline, Halbeath, Fife, UK
F. Lenihan
Affiliation:
NHS Lothian, Orchard Clinic, Royal Edinburgh Hospital, Edinburgh, UK
A. Rowe
Affiliation:
Medicines Management Team, NHS Lothian, Edinburgh, UK
*
*Address for correspondence: Dr F. Williams, NHS Fife, Learning Disability Service, Lynebank Hospital, Dunfermline, Halbeath, Fife KY8 4NZ, UK. (Email: fionnuala.williams@nhs.net)
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Abstract

A patient in a medium secure psychiatric unit with a 19-year history of treatment-resistant schizophrenia and violence whose mental illness only responded to clozapine, was noted to have a sustained tachycardia. Echocardiography revealed mild biventricular cardiomyopathy. The patient was not significantly affected by this. Initial recommendation from Cardiology was to consider discontinuation of clozapine. It was decided, however, that the risk of worsening psychosis and resultant violence outweighed the risk of the patient’s relatively mild cardiomyopathy. The patient was commenced on ramipril, and later bisoprolol. The patient no longer requires treatment in a medium secure unit and has remained on clozapine with follow-up from cardiology.

Keywords

Cardiomyopathyclozapineforensicsschizophrenia
Type
Case Report
Information
Irish Journal of Psychological Medicine , Volume 38 , Issue 3 , September 2021 , pp. 227 - 231
Copyright
© College of Psychiatrists of Ireland 2018

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