A case of hypotension and heart rate changes on rechallenge with a low dose of clozapine with no apparent secondary cause

Clozapine is known to cause innocuous as well severe and or fatal cardiovascular side effects. These effects are commonly reported at the initiation of clozapine therapy. We report a patient who was stable on for several years but in whom we had withhold medical reasons subsequently developed significant hypotension heart rate changes when rechallenged with small dose clozapine.