Besides agranulocytosis, which risks are associated with clozapine?

• A. Diabetes and weight gain
• B. Myocarditis and seizures
• C. Liver failure and pancreatitis
• D. Kidney injury and electrolyte imbalance

Answer: (B)

Clozapine carries several serious adverse effects beyond agranulocytosis, and two particularly important ones are myocarditis and seizures. Myocarditis tends to occur early in treatment, with symptoms like chest pain, shortness of breath, fever, or fatigue; clinicians watch for this with clinical signs and sometimes biomarkers (such as CRP and troponin) and cardiac monitoring, because it can be life-threatening if not recognized quickly. Seizures are another key risk, and they’re more likely at higher doses or with rapid dose increases, especially in patients with other seizure risk factors; minimizing this risk involves slow up-titration, dose adjustments, and, in some cases, anticonvulsant strategies. While diabetes and weight gain are real metabolic risks seen with clozapine, the combination of myocarditis and seizures represents the other major, acute safety concerns clinicians focus on beyond agranulocytosis.