Managing Cardiac and Metabolic Adverse Effects of Clozapine
Abstract
Myocarditis risk is higher during clozapine initiation. Monitor CRP, CK, and troponin I weekly for the first 6–8 weeks to mitigate myocarditis risk. Stop clozapine immediately for any cardiorespiratory complaints that occur during titration. Tachycardia and orthostasis are common but manageable adverse effects of clozapine. Lifestyle modifications and adjunctive pharmacologic treatments can help mitigate the metabolic syndrome risk of clozapine. Topiramate and metformin can be used prophylactically in collaboration with the patient.
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