Clozapine-induced, dilated cardiomyopathy: a case report

BACKGROUND: Clozapine is known to be a highly effective antipsychotic agent and additionally provides a significant reduction in suicide-risk and aggression. Clozapine-induced cardiomyopathy is a very rare but nonetheless dangerous side-effect, with an incidence of 0.02–0.1%, depending on the literature, and a mortality rate of up to 17.9%. CASE PRESENTATION: We report on the case of a 25 year-old patient, who was admitted for the evaluation of a potential electroconvulsive therapy due to persistent auditory hallucinations under clozapine. Shortly after admission he was found to be suffering from dilated cardiomyopathy, likely caused by his antipsychotic treatment. CONCLUSION: Clozapine-induced cardiomyopathy should be taken into account when monitoring patients treated with this antipsychotic and regular electrocardiograms should be performed in order to detect possible alterations as soon as possible.