Echocardiographic monitoring for clozapine cardiac toxicity: lessons from real-world experience

Murch, S.; Tran, Nga; Liew, Danny; Petrakis, Melissa; Prior, David; Castle, David

doi:10.1177/1039856213475684

Cited by 36 publications

(25 citation statements)

References 17 publications

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“…An Italian study suggested that N5% decrease in left ventricular (LV) ejection fraction occurred in one third of patients initiated on clozapine at one year follow-up [20]. Although our clinical experience includes several incidences where clozapine induced cardiomyopathy was referred to cardiology in the setting of incidentally noted reduced ejection fraction during preoperative evaluation, this has only been reported in two cases [21,22].…”

Section: Disease Frequencymentioning

confidence: 91%

See 1 more Smart Citation

A systematic review of clozapine induced cardiomyopathy

Alawami

Wasywich

Cicović

et al. 2014

International Journal of Cardiology

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Section: Disease Frequencymentioning

confidence: 91%

“…Chest pain was only reported in 2 cases. 2 asymptomatic patients were found to have cardiomyopathy on routine echocardiographic testing [21,22].…”

Section: Presenting Symptoms and Signsmentioning

confidence: 99%

A systematic review of clozapine induced cardiomyopathy

Alawami

Wasywich

Cicović

et al. 2014

International Journal of Cardiology

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“…There is little evidence that the cardiac adverse events can be predicted, but baseline echocardiogram and troponin are advisable. Regular echocardiograms do not have a strong evidence base and it has been suggested that they be undertaken only if clinically indicated (Murch et al, 2013;Ronaldson et al, 2011). Metabolic monitoring and advice about diet and exercise are essential.…”

Section: Treatment Resistance and Clozapinementioning

confidence: 99%

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders

Galletly

Castle

Dark

et al. 2016

Aust N Z J Psychiatry

Self Cite

641

672

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Objectives: This guideline provides recommendations for the clinical management of schizophrenia and related disorders for health professionals working in Australia and New Zealand. It aims to encourage all clinicians to adopt best practice principles. The recommendations represent the consensus of a group of Australian and New Zealand experts in the management of schizophrenia and related disorders. This guideline includes the management of ultra-high risk syndromes, first-episode psychoses and prolonged psychoses, including psychoses associated with substance use. It takes a holistic approach, addressing all aspects of the care of people with schizophrenia and related disorders, not only correct diagnosis and symptom relief but also optimal recovery of social function. Methods:The writing group planned the scope and individual members drafted sections according to their area of interest and expertise, with reference to existing systematic reviews and informal literature reviews undertaken for this guideline. In addition, experts in specific areas contributed to the relevant sections. All members of the writing group reviewed the entire document. The writing group also considered relevant international clinical practice guidelines. Evidence-based recommendations were formulated when the writing group judged that there was sufficient evidence on a topic. Where evidence was weak or lacking, consensus-based recommendations were formulated. Consensus-based recommendations are based on the consensus of a group of experts in the field and are informed by their agreement as a group, according to their collective clinical and research knowledge and experience. Key considerations were selected and reviewed by the writing group. To encourage wide community participation, the Royal Australian and New Zealand College of Psychiatrists invited review by its committees and members, an expert advisory committee and key stakeholders including professional bodies and special interest groups. RANZCP GuidelinesGalletly et al. 411 Australian & New Zealand Journal of Psychiatry, 50(5)Results: The clinical practice guideline for the management of schizophrenia and related disorders reflects an increasing emphasis on early intervention, physical health, psychosocial treatments, cultural considerations and improving vocational outcomes. The guideline uses a clinical staging model as a framework for recommendations regarding assessment, treatment and ongoing care. This guideline also refers its readers to selected published guidelines or statements directly relevant to Australian and New Zealand practice. Conclusions:This clinical practice guideline for the management of schizophrenia and related disorders aims to improve care for people with these disorders living in Australia and New Zealand. It advocates a respectful, collaborative approach; optimal evidence-based treatment; and consideration of the specific needs of those in adverse circumstances or facing additional challenges.

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“…Many patients with treatment-resistant BD may achieve remission or response with clozapine [88••]. Despite proven effectiveness in severe BD, major concerns regarding toxicity (hematological, neurological, cardiovascular and hepatic), medical comorbidities (metabolic disturbances and cardiovascular disorders), and significant side effect profile (weight gain, sedation, acute delirium, and cognitive disturbances) continue to limit clozapine prescription [89][90][91].…”

Section: Addressing Functional Impairment In Severe Bipolar Disordermentioning

confidence: 99%

Staging Models and Functional Outcomes in Bipolar Disorder: Clinical Implications

Passos

Kapczinski

Quevedo

et al. 2015

Curr Treat Options Psych

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Echocardiographic monitoring for clozapine cardiac toxicity: lessons from real-world experience

Cited by 36 publications

References 17 publications

A systematic review of clozapine induced cardiomyopathy

A systematic review of clozapine induced cardiomyopathy

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders

Staging Models and Functional Outcomes in Bipolar Disorder: Clinical Implications

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