Letter to the Editor October 11, 2018

Clozapine-Induced Myocarditis: The Heartfelt Silent Assassin

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Prim Care Companion CNS Disord 2018;20(5):17l02256

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To the Editor: In the United States, there are approximately 3.2 million people—1.2% of the population—with a diagnosis of schizophrenia. While this percentage only represents a small fraction of the total population, it is estimated that one-third of these individuals have treatment-resistant schizophrenia. Although clozapine is the only US Food and Drug Administration (FDA)-approved antipsychotic for treatment-resistant schizophrenia, its use is limited by its unique and rather intimidating side effect profile, including agranulocytosis (incidence of approximately 1%) and myocarditis (incidence of approximately 3%).