An unexpected side effect related to the use of clozapine: Neutrophilic leukocytosis and brief review of the literature

Evaluation of Anticonvulsant-Induced Leukocytosis: A Review of Evidence for Carbamazepine, Lamotrigine, and Phenobarbital

“…The exact mechanism underlying drug-induced leukocytosis with anticonvulsant medications is not fully understood and may vary depending on the specific medication; however, there are several proposed mechanisms that could contribute to this finding. 2-5 Hypersensitivity reactions may lead to an immune-mediated hypersensitivity reaction, resulting in an increase in the white blood cell (WBC) count. This type of leukocytosis is typically associated with other symptoms such as fever, rash, and organ involvement and may include diagnoses such as drug reaction with eosinophilia and systemic symptoms (DRESS), drug-induced hypersensitivity syndrome (DIHS), Stevens-Johnson syndrome, or toxic epidermal necrolysis.…”

“…This type of leukocytosis is typically associated with other symptoms such as fever, rash, and organ involvement and may include diagnoses such as drug reaction with eosinophilia and systemic symptoms (DRESS), drug-induced hypersensitivity syndrome (DIHS), Stevens-Johnson syndrome, or toxic epidermal necrolysis. 2-5 It is important to differentiate hypersensitivity-induced leukocytosis from other causes and promptly manage the underlying reaction. It has also been noted that anticonvulsants may exert immunomodulatory effects on the immune system, leading to alterations in WBC counts.…”

“…Finally, literature elucidating leukocytosis associated with anticonvulsant medications as an idiosyncratic reaction was evaluated. 2-5…”