Otsuka Yuji, Idemoto Keita, Hosoda Yutaka, Imamura Yukitsugu, Aoki Tsutomu
Department of Psychiatry Asahi General Hospital Asahi City Japan.
Department of Psychiatry, Graduate School of Medicine Chiba University Chiba-shi Japan.
J Gen Fam Med. 2019 Feb 27;20(3):114-117. doi: 10.1002/jgf2.239. eCollection 2019 May.
Schizophrenia patients have significantly lower life expectancy than the general population. Clozapine is the most effective antipsychotic to reduce the mortality rate in these patients. Here, we report a schizophrenic patient with clozapine-induced myocarditis and successful retrial. In the first trial, clozapine was discontinued due to myocarditis. In the second trial, the titration rate was slower, and sodium valproate was not coadministered with clozapine. The patient has not developed myocarditis over 3.5 years of observation. It may be possible to take clozapine for a long time even after clozapine-induced myocarditis, and thus improve the life expectancy of schizophrenia patients.
精神分裂症患者的预期寿命显著低于普通人群。氯氮平是降低这些患者死亡率最有效的抗精神病药物。在此，我们报告一例氯氮平诱发心肌炎且再次试用成功的精神分裂症患者。在首次试用中，因心肌炎停用氯氮平。在第二次试用中，滴定速度较慢，且丙戊酸钠未与氯氮平联合使用。经过3.5年的观察，该患者未再发生心肌炎。即使在氯氮平诱发心肌炎后，也有可能长期服用氯氮平，从而提高精神分裂症患者的预期寿命。
