Arrhythmia induced by clozapine in patients with schizophrenia： a Meta-analysis

BackgroundClozapine belongs to atypical antipsychotic drugs that has shown significant efficacy in treating schizophrenia. However， clozapine can induce arrhythmias in patients. Currently， there is a lack of systematic research on the types and incidence of clozapine-induced arrhythmias.ObjectiveTo explore the types and incidence of arrhythmias in patients with schizophrenia induced by clozapine through Meta-analysis， so as to provide references for clinical treatment.MethodsOn October 31， 2022， a search was conducted through PubMed， Embase， Cochrane Library and China National Knowledge Infrastructure （CNKI） to collect relevant literature on clozapine-induced arrhythmia in patients with schizophrenia. Joanna Briggs Institute （JBI） was used to evaluate the quality of the included literature. Meta-analysis was conducted using Review Manager 5.4.ResultsA total of 12 studies were included， involving 42 490 schizophrenia patients taking clozapine. The incidence of arrhythmias caused by clozapine was 23% （95% CI： 0.16~0.29）. Among them， the incidence of tachycardia was 25% （95% CI： 0.15~0.35）， atrial arrhythmia was 6% （95% CI： -0.02~0.14）， ventricular arrhythmia was 7% （95% CI： -0.02~0.16）， conduction block was 2% （95% CI： 0~0.04）， QTc prolongation was 4% （95% CI： -0.04~0.12） and T-wave changes was 23% （95% CI： 0.16~0.30）.ConclusionSchizophrenia patients taking clozapine may increase their risk of developing arrhythmia， with tachycardia being the most prevalent. ［Funded by Graduate Innovation Fund of Kunming Medical University （number， 2023S302）］