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Intravenous Immunoglobulin and Methylprednisolone for Clozapine-Associated Perimyocarditis

Cheng, Albert MD; Ahmed, Mohanned MD; Shuaib, Waqas MD*

doi: 10.1097/MJT.0000000000000751
Therapeutic Challenges

Clinical Features: Cardiotoxicity is a rare but serious side effect of clozapine. We present a case of a psychiatric patient on chronic clozapine 75 mg daily, who presented with congestive heart failure secondary to the cardiotoxic effects of the psychiatric medication.

Therapeutic Challenge: Conventional heart failure treatment failed to improve symptoms.

Solution: A course of 40 mg of intravenous immunoglobulin and 125 mg of steroids was implemented, after which the patient made a full recovery. We hope to raise awareness of concurrent clozapine-induced pericarditis and myocarditis and propose a role of intravenous immunoglobulin and steroids in the treatment of drug-induced cardiomyopathy.

Wichita Falls Family Practice Residency Program, Wichita Falls, TX.

Address for correspondence: Wichita Falls Family Practice Residency Program, 1301 3rd St, Suite 200, Wichita Falls, TX 76301. E-mail:

The authors have no conflicts of interest to declare.

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