title: Ivabradine, a novel treatment for clozapine-induced sinus tachycardia: a case series.
abstract: OBJECTIVE
  Clozapine is the most efficacious treatment for treatment-resistant schizophrenia; however its use can be limited by intolerability. Sinus tachycardia is a common adverse event associated with clozapine use, which may lead to the premature discontinuation of clozapine. Traditionally, β blockers are used to treat clozapine-associated tachycardia, though problems with intolerability and ineffectiveness can limit their utility.
  
  
  METHODS
  In this article, we present two cases of patients with treatment-resistant schizophrenia who developed symptomatic tachycardia associated with clozapine therapy.
  
  
  RESULTS
  We demonstrate that the novel heart rate controlling agent ivabradine can be effectively and safely used to control the heart rate and to allow for continued treatment with clozapine.
  
  
  CONCLUSIONS
  This is the first report in the literature demonstrating that ivabradine appears to be a well tolerated agent, which should be considered as a symptomatic treatment of clozapine-induced tachycardia if the use of a β blocker fails due to a lack of response or intolerability.
authors: Department of Psychosis Studies, King's College London and National Psychosis Service, South London and Maudsley NHS Foundation Trust, London SE5 8AF, UK.
authors: John
authors: J
authors: Lally
authors: National Psychosis Services, South London and Maudsley NHS Foundation Trust, London, UK.
authors: Jennifer
authors: J
authors: Brook
authors: National Psychosis Services, South London and Maudsley NHS Foundation Trust, London, UK.
authors: Thomas
authors: T
authors: Dixon
authors: National Psychosis Services, South London and Maudsley NHS Foundation Trust, and Department of Psychosis Studies, Institute of Psychiatry, Kings College London, London, UK.
authors: Fiona
authors: F
authors: Gaughran
authors: National Psychosis Services, South London and Maudsley NHS Foundation Trust, and Department of Psychosis Studies, Institute of Psychiatry, Kings College London, London, UK.
authors: Sukhi
authors: S
authors: Shergill
authors: Cardiology Unit, King's College Hospital, London, UK.
authors: Narbeh
authors: N
authors: Melikian
authors: National Psychosis Services, South London and Maudsley NHS Foundation Trust, and Department of Psychosis Studies, Institute of Psychiatry, Kings College London, London, UK.
authors: James H
authors: JH
authors: MacCabe
keywords: clozapine; ivabradine; tachycardia; treatment-resistant schizophrenia; β blockers