The Drug-Induced Respiratory Disease Website

Clozapine

Cardiomyopathy (acute, subacute, chronic)

In one case (PMID 26664756) left ventricular thrombus was present

Im JP, Pellegrini JR, Munshi R, Rankov L, Makaryus AN

"My Heart Said It's Swollen": A Rare Case of Clozapine-Induced Myocarditis in a Schizophrenic Patient.

Cureus 2021 May 22;13;e15168 — 2021 May 22 — e15168

Malik SA, Malik S, Dowsley TF, Singh B

Left Ventricular Thrombus as a Complication of Clozapine-Induced Cardiomyopathy: A Case Report and Brief Literature Review.

Case reports in cardiology 2015;2015;835952 — 2015 — 835952

Makhoul B, Hochberg I, Rispler S, Azzam ZS

Dilated cardiomyopathy: an unusual complication of clozapine therapy.

Nature clinical practice. Cardiovascular medicine 2008 Sep;5;566-70 — 2008 Sep — 566-70

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

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