Ronaldson KJ, Fitzgerald PB, Taylor AJ et al.
Monash University, Melbourne, VIC, Australia.
Aust NZ J Psychiatry 2011;45:458–65.
Editor’s note: There is a recognized association between the use of clozapine and myocarditis (Lancet 1999;354:1841–5). The objective of the current study was to develop a monitoring protocol for myocarditis in patients who were starting clozapine treatment. Seventy-five cases of myocarditis were examined, nine of which were fatal. In 83% of the cases, the onset occurred between days 14 and 21 of clozapine initiation. The control group consisted of patients who took clozapine for ≥45 days and in whom the possibility of myocarditis could be excluded (as evidenced by a lack of tachycardia, no rise in troponin levels, or a normal echocardiogram), and patients who took clozapine for ≥6 months and showed no evidence of developing cardiac disease.