Case Report: Clozapine-Induced Myocarditis in a Patient with Autism Spectrum Disorder and Schizophrenia

Beebani, Ganj; Fabian, Nina; Bhatia, Nona; Sivananthan, Mauran

doi:10.1007/s10803-021-05174-7

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…Clinical monitoring enabled the proper detection and management of these effects without severe consequences. Seven patients (5.7%) discontinued treatment due to adverse effects (Beebani et al, 2022; Bell et al, 2018; Estay et al, 2018; Grubisha et al, 2014; Scala et al, 2023; Skarpathiotakis and Westreich, 2005; Watchel et al, 2015 ) . Scala et al (2023) and Bell et al (2018) reported cases where clozapine exacerbated obsessive-compulsive symptoms despite alleviating psychiatric symptoms, leading to treatment interruption.…”

Section: Resultsmentioning

confidence: 99%

“…The patient recovered completely within weeks after clozapine cessation and therapy with a beta-blocker agent. Beebani et al (2022) reported a case of myocarditis in a 21-year-old patient with ASD who presented schizophrenia, arising 3 weeks after adjusting the dose of clozapine at 150 mg/day and resolving upon its discontinuation. Drawing on data about the incidence rates, these authors advocate for the weekly monitoring of C-reactive protein and troponin levels during the first 6 weeks of clozapine therapy, aiming to detect clozapine-induced myocarditis for timely intervention.…”

Section: Resultsmentioning

confidence: 99%

“…Excessive sedation led to decreased doses of clozapine or other sedatives. Specific symptoms such as sialorrhea, tachycardia, and constipation received targeted symptomatic treatments (Akça et al, 2022; Beebani et al, 2022; Rhee et al, 2022). Lithium reversed a case of mild leukopenia (Rothärmel et al, 2018).…”

Section: Resultsmentioning

confidence: 99%

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Exploring clozapine use in severe psychiatric symptoms associated with autism spectrum disorder: A scoping review

da Rosa,

Bezerra,

Rohde

et al. 2024

J Psychopharmacol

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Background: Patients with autism spectrum disorder (ASD) may experience severe psychiatric symptoms, often unresponsive to conventional pharmacological therapies, highlighting the need for more effective alternatives. Aims: This study aims to map and synthesize evidence on the use of clozapine as a therapeutic option for managing severe psychiatric symptomatology co-occurring with ASD. Methods: We conducted a scoping review on multiple sources following the JBI guidelines. The search strategy was inclusive, targeting both peer-reviewed publications and gray literature presenting empirical data on the use of clozapine therapy for patients with ASD accompanied by comorbid psychiatric symptoms. Two independent evaluators performed the selection of studies, data extraction, and critical appraisal. Results: The review included 46 studies, encompassing 122 ASD individuals who received clozapine therapy. The sources of evidence comprise 31 case reports, 8 case series, 6 retrospective observational studies, and 1 quasi-experimental prospective study. The tables present the findings along with a narrative summary. Clozapine treatment demonstrated benefits in four groups of severe and treatment-resistant psychiatric symptoms in ASD patients: disruptive behaviors, psychotic symptoms, catatonia, and mood symptoms. Although side effects were common, tolerability was generally satisfactory. However, severe adverse events, such as seizures, moderate neutropenia, and myocarditis, underscore the need for intensive clinical monitoring. Conclusions: While clozapine shows promise as a pharmacological intervention for severe psychopathologies in ASD, more rigorous clinical studies are required to elucidate its efficacy and safety in this population. The limited robustness of the evidence calls for caution, signaling an early research stage into this topic.

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