Ivabradine, a novel treatment for clozapine-induced sinus tachycardia: a case series.

Abstract

OBJECTIVES:

Clozapine is the most efficacious treatment for treatment-resistant schizophrenia; however its use can be limited by intolerability. Sinus tachycardia is a common adverse event associated with clozapine use, which may lead to the premature discontinuation of clozapine. Traditionally, β blockers are used to treat clozapine-associated tachycardia, though problems with intolerability and ineffectiveness can limit their utility.

METHODS:

In this article, we present two cases of patients with treatment-resistant schizophrenia who developed symptomatic tachycardia associated with clozapine therapy.

RESULTS:

We demonstrate that the novel heart rate controlling agent ivabradine can be effectively and safely used to control the heart rate and to allow for continued treatment with clozapine.

CONCLUSION:

This is the first report in the literature demonstrating that ivabradine appears to be a well tolerated agent, which should be considered as a symptomatic treatment of clozapine-induced tachycardia if the use of a β blocker fails due to a lack of response or intolerability.

• Authors: John Lally, Jennifer Brook, Thomas Dixon, Fiona Gaughran, Sukhi Shergill, Narbeh Melikian, James H MacCabe
• Journal: Therapeutic advances in psychopharmacology (Ther Adv Psychopharmacol) Vol. 4 Issue 3 Pg. 117-22 (Jun 2014) ISSN: 2045-1253 [Print] England
• PMID: 25057344 (Publication Type: Journal Article)