Clozapine‐Related Arterial Hypertension in a Man With Resistant Schizophrenia: A Case Report

Abstract

Introduction Clozapine is an atypical antipsychotic widely used in treatment‐resistant schizophrenia. While it is commonly associated with orthostatic hypotension, clozapine‐induced hypertension is a rare but reported adverse effect with unclear mechanisms. Patient Information We report the case of a 26‐year‐old with treatment‐resistant schizophrenia, without significant medical history, hospitalized after a suicide attempt. Clinical Findings Shortly after clozapine initiation with gradual dose titration, the patient developed sustained hypertension (up to 170/90 mmHg) without any other identifiable cause. Cardiac evaluations, laboratory tests, and imaging studies excluded alternative etiologies. Clozapine therapy was continued due to therapeutic resistance, with the addition of antihypertensive medications (nicardipine and rilmenidine) and close blood pressure monitoring. Conclusion Although rare, clozapine‐induced hypertension requires increased clinical awareness, especially during the early weeks of treatment. Systematic blood pressure monitoring is essential to timely identify and manage this cardiovascular risk.