Increased cardiovascular
risk linked with clozapine
Patients taking clozapine are at an increased
risk of developing metabolic syndrome, the
authors of a recent study conclude (American
Journal of Psychiatry 2006;163:1273).
In an analysis of 93 patients taking clozapine
versus 2,701 comparison subjects, metabolic
syndrome — characterised by the
existence of certain risk factors for increased
cardiovascular morbidity and mortality —
was found to be more prevalent in the clozapine
group (53.8 per cent) than in the comparison
group (20.7 per cent; P<0.001).
The authors list the lack of randomisation,
lack of non-medicated schizophrenia patients
as controls and lack of patient follow-up as
limitations of the study, along with its inability
to determine the extent to which the higher
prevalence was attributable to clozapine.
David Taylor, chief pharmacist, South
London and Maudsley NHS Trust, said:“This
study demonstrates just how prevalent the
syndrome is in people on clozapine — much
more prevalent than one might have predicted.
There is clearly a need for close monitoring
of metabolic parameters in all people
treated with antipsychotics,” said Dr Taylor. “Unfortunately, such close monitoring is a
rarity in practice,” he added.
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