Reactions 1488, p13 - 15 Feb 2014

SClozapine

Unmasking of Brugada pattern: case reportA 47-year-old man experienced unmasking of Brugada

pattern while receiving clozapine for schizophrenia.The man presented with cough, dyspnoea, orthopnoea and

fever for 3 days, and one episode of syncope. His medicalhistory was significant for treatment-resistant schizophrenia,and he had recently been commenced on clozapine [route anddosage not stated]. A physical examination showedtachycardia and fever. An EKG demonstrated a new RSR’pattern in V1 and V2 with a coved ST-segment elevation inV1–V3, consistent with a type 1 Brugada pattern.

The man’s clozapine was stopped, and his Brugada patternresolved spontaneously after 24 hours. His tachycardia andfever resolved 72 hours after presentation, following treatmentfor underlying community-acquired pneumonia.

Author comment: "This case illustrates that clozapine mayunmask Brugada pattern and this has implications inestablishing guidelines for monitoring therapy."Ukaigwe A, et al. Clozapine and brugada-unlikely but true. Journal of GeneralInternal Medicine 28: S302, Jun 2013. Available from: URL: http://link.springer.com/journal/11606 [Abstract]. - USA 803099404

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Reactions 15 Feb 2014 No. 14880114-9954/14/1488-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved