{
  "abstract": "Clozapine is the only antipsychotic with established efficacy for treatment-resistant schizophrenia and remains recommended in the UK and the USA for this indication. For many patients, it is not simply the best option but the only antipsychotic with established efficacy in treatment-resistant schizophrenia, often conferring the greatest likelihood of clinically meaningful recovery, though response remains heterogeneous. Despite its unparalleled benefits, clinicians frequently interrupt or discontinue clozapine at the first sign of possible cardiotoxicity. Because reinitiation in these circumstances is uncommon, these decisions often have lifelong consequences. This viewpoint argues that psychiatry should draw inspiration from cardio-oncology, where the concept of permissive cardiotoxicity has transformed the management of essential but high-risk therapies. A similar approach could allow more patients to maintain access to clozapine while still protecting cardiovascular safety.",
  "authors": [
    {
      "affiliations": [
        "Department of Cardiology, Hammersmith Hospital, London, UK"
      ],
      "name": "Carla M Plymen"
    },
    {
      "affiliations": [
        "King’s College Hospital, London, UK"
      ],
      "name": "David M Taylor"
    },
    {
      "affiliations": [
        "King’s College Hospital, London, UK"
      ],
      "name": "Susan E Piper"
    }
  ],
  "title": "Clozapine, cardiotoxicity and the case for permissive risk in psychiatry",
  "uid": "13539204-8863-5bea-b713-6c144ad32c31"
}