Clozapine-related tachycardia: A conundrum to identify and treat

Abstract

Objective This study examined the rates and persistence of clozapine-induced tachycardia and heart-rate differences in patients treated with β-blockers in the largest sample of patients with a psychotic disorder to date. Method An audit of medical files for 101 patients who attended a clozapine community clinic and analysis of monthly measurements of resting heart rates. Results 51% met the clinical criteria for tachycardia. Heart rates were stable over time. β-blockers were associated with small but significant reductions in heart rates. Conclusion The cardiovascular risks of clozapine are often overlooked. β-blockers are useful in lowering heart rates but they may be insufficient to reduce cardiac risk.