Takotsubo Cardiomyopathy in a Young Man After Maintenance Electroconvulsive Therapy and Clozapine Initiation

CNS disease triggering Takotsubo stress cardiomyopathy

“…In 6 patients TTS occurred after the first ECT and in 7 patients after repeated ECTs [33]. TTS has also been reported in patients undergoing maintenance electroconvulsive therapy after clozapine initiation [146]. Altogether 16 cases have been reported who developed TTS after ECT.…”

“…TTS has been reported as an early complication of this treatment, which may occur with or without concomitant neuroleptic therapy [33]. So far, 15 patients have been reported who developed TTS after ECT [33,[146][147][148][149]. Fourteen of the patients were female and one was male.…”

Combined use of clozapine and ECT: a review

“…In terms of fatality, only one case report described fatal outcome in a patient 3 weeks after the last ECT, who developed supraventricular tachycardia (32). Another report described development of Takotsubo cardiomyopathy few hours after the last ECT while on clozapine (24). Some of the recent studies have specifically assessed cognitive functions of patients receiving the combined treatment and One patient remained well for at least 6 weeks on clozapine after completion of ECT One patient remained weak with maintenance ECT and clozapine for 2 months Klapheke (15) Schizoaffective disorder, mania 1 Remained well for at least 3 weeks on clozapine after completion of ECT Safferman and Munne (54) Schizophrenia 1 Remained well for at least 3 weeks on clozapine after completion of ECT Factor et al (30) Psychosis related to Parkinson's disease Only one of the six patients became disturbed again after 6 months Kales et al (31) Schizophrenia (four of the five patients were clozapine-resistant) 5 Improvement sustained for less than 4 months in three of the five patients Long-term outcome -not good for most patients Chanpattana et al (52) Bipolar disorder, mania 1 Improved, maintained well for the 18-month period Kho et al (26) Schizophrenia (clozapine nonresponders) 11 During the mean follow-up duration of 16 (range 4-42) weeks, five patients had relapse of symptoms after the initial response.…”

Takotsubo cardiomyopathy and its relevance to anesthesiology: a narrative review

“…193,194 Interestingly, in eight patients, the TTCM occurred after the patient had previously undergone ECT treatments uneventfully. Only one of the six patients who underwent subsequent ECT treatments had a recurrence of TTCM.…”