Abstract
OBJECTIVE: Using national Danish registers, we estimated rates of clozapine-associated cardiac adverse events. Rates of undiagnosed myocarditis were estimated by exploring causes of death after clozapine initiation.
METHOD: Through nationwide health registers, we identified all out-patients initiating antipsychotic treatment (January 1, 1996-January 1, 2015). Rates of clozapine-associated myocarditis and pericarditis within 2 months from clozapine initiation and rates of cardiomyopathy within 1-2 years from clozapine initiation were compared to rates for other antipsychotics. Mortality within 2 months from clozapine initiation was extracted.
RESULTS: Three thousand two hundred and sixty-two patients of a total 7932 patients initiated clozapine as out-patients (41.12%). One patient (0.03%) developed myocarditis, and no patients developed pericarditis within 2 months from clozapine initiation. Two (0.06%) and four patients (0.12%) developed cardiomyopathy within 1 and 2 years respectively. Rates were similar for other antipsychotics. Twenty-six patients died within 2 months from clozapine initiation. Pneumonia (23.08%) and stroke (11.54%) were the main causes of death. We estimated the maximum rate of clozapine-associated fatal myocarditis to 0.28%.
CONCLUSION: Cardiac adverse effects in Danish out-patients initiating clozapine treatment are extremely rare and these rates appear to be comparable to those observed for other antipsychotic drugs.
Original language | English |
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Journal | Acta Psychiatrica Scandinavica |
Volume | 137 |
Issue number | 1 |
Pages (from-to) | 47-53 |
Number of pages | 7 |
ISSN | 0001-690X |
DOIs | |
Publication status | Published - 2018 |
Keywords
- Journal Article
- pericarditis
- myocarditis
- antipsychotics
- mortality
- clozapine
- cardiomyopathy
- Danish nationwide registers
- Humans
- Middle Aged
- Male
- Antipsychotic Agents/therapeutic use
- Psychotic Disorders/drug therapy
- Adult
- Female
- Registries
- Schizophrenia/drug therapy
- Pericarditis/epidemiology
- Bipolar Disorder/drug therapy
- Ambulatory Care
- Clozapine/therapeutic use
- Denmark/epidemiology
- Myocarditis/epidemiology
- Cardiomyopathies/epidemiology
- Aged