Echocardiographic monitoring for clozapine-associated cardiac toxicity — time for review?

Stuart D Murch, David L Prior and David J Castle
Med J Aust 2013; 198 (2): . || doi: 10.5694/mja11.11394
Published online: 4 February 2013

To the Editor: Clozapine therapy is a recognised risk factor for myocarditis and cardiomyopathy; however, there are no national guidelines for cardiac monitoring. Similar to many centres in Australia, and consistent with the consensus view from major psychiatric facilities in Victoria,1 our institution’s policy is to monitor patients with a baseline echocardiogram before starting treatment with clozapine, at 6 months and 12 months after starting treatment, and once per year thereafter.

  • Stuart D Murch
  • David L Prior
  • David J Castle

  • St Vincent’s Hospital, Melbourne, VIC.



We thank Melissa Petrakis, Nga Tran and Danny Liew for assistance with data collection and review of the manuscript.

Competing interests:

St Vincent’s Hospital Melbourne has received an investigator-initiated grant from Hospira.


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