# 239 - References

# References

240
The Maudsley® Prescribing Guidelines in Psychiatry
CHAPTER 1
Serious cardiac adverse effects
See section on clozapine: serious cardiovascular adverse effects in this chapter. Patients 
should be closely observed for signs or symptoms of myocarditis, particularly during 
the first month,7 and advised to inform staff if they experience cardiac symptoms and 
to seek out-­of-­hours review if necessary. These symptoms include persistent tachycardia 
(although commonly benign), palpitations, shortness of breath, fever, arrhythmia, 
symptoms mimicking myocardial infarction, chest pain, unusually low blood pressure 
and other unexplained symptoms of heart failure. Myocarditis risk is probably lower 
when using the slow titrations used in the community.8
References
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221:740–747.
2. Beck K, et  al. The practical management of refractory schizophrenia—the Maudsley Treatment REview and Assessment Team service 
approach. Acta Psychiatr Scand 2014; 130:427–438.
3. Taylor DM, et al. The Maudsley Prescribing Guidelines in Psychiatry, 14th edn. Oxford: Wiley-Blackwell; 2021.
4. Mizuno Y, et al. Low-­frequency monitoring for community clozapine initiations: a comparative study relative to standard frequency assessments. J Psychopharm 2023; 37:627–629.
5. Taylor D, et al. Predicting clozapine dose required to achieve a therapeutic plasma concentration: a comparison of a population algorithm and 
three algorithms based on gene variant models. J Psychopharmacol 2023; 37:1030–1039.
6. Clark SR, et al. Dotting the I’s and crossing the T’s: a South Australian perspective on variability in troponin thresholds for myocarditis risk in 
clozapine treatment. Schizophr Res 2023; 268:114–117.
7. Correll CU, et al. A guideline and checklist for initiating and managing clozapine treatment in patients with treatment-­resistant schizophrenia. 
CNS Drugs 2022; 36:659–679.
8. de Leon J, et al. Escaping the long shadow cast by agranulocytosis: reflections on clozapine pharmacovigilance focused on the United Kingdom. 
J Clin Psychopharmacol 2023; 43:239–245.