Anxiolytic Drugs

Saah, Tammy; Garlow, Steven J.; Rapaport, Mark Hyman; Edwards, Deidre M.; Hale, Kathryn L.; Maddux, Rachel

doi:10.1002/9781118753378.ch106

Cited by 1 publication

(1 citation statement)

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“…Therefore, clinicians prescribing the medication are presented with the increased burden of controlling multiple and complex psychiatric disorders, finding the medication that provides a patient with the most relief from their mood disturbances, and hoping side effects from polypharmacy do not arise. For this reason, recent studies have revisited testing on monotherapy regimens as a means to avoid unwanted and synergized side effect profiles with the hopes of providing the efficacy of polypharmacy [16,17]. Studies have also called for the development of guidelines to better understand polypharmacy for those cases where monotherapy is not adequate to control multiple psychiatric conditions [2].…”

Section: Discussionmentioning

confidence: 99%

Agranulocytosis Associated With Psychiatric Polypharmacy: Lessons Learned From a Clinical Case

Villa,

Pausescu,

Espiridion

2024

Cureus

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Psychiatric polypharmacy involves the use of two or more psychotropic medications to manage a mental and emotional condition. The prevalence of psychotropic polypharmacy has been increasing since the 1990s and has been attributed to the rise in multiple psychiatric conditions presenting in one patient. However, as the prevalence of polypharmacy increases to maximize therapeutic advantages, so does the adverse effect profile of those drugs used in combination, leading to very life-threatening effects such as agranulocytosis. Thus, we report a case of agranulocytosis secondary to polypharmacy in a patient with a history of multiple complex psychiatric conditions. The patient is a 20-year-old female with a past medical history of major depressive disorder, borderline personality disorder, post-traumatic stress disorder, anxiety disorder, hypothyroidism, and ulcerative colitis. Her psychiatric conditions were managed with multiple medications including chlorpromazine, and clozapine was recently added a month prior to admission. Upon admission, the patient was hemodynamically stable and febrile, with complaints of generalized body aches and myalgia. Laboratory results showed profound leukopenia with a white blood cell count of 1.0x10 3 /uL and a neutrophil number of 0.02x10 3 /uL. The patient was admitted to the hospital for neutropenic sepsis and was aggressively treated with intravenous antibiotics. Her clozapine and chlorpromazine were discontinued. In this report, we discuss the association between chlorpromazine and clozapine use and agranulocytosis, emphasizing the importance of regular monitoring and heightened awareness for patients on these medications. This case also underscores the necessity for cautious polypharmacy medication management in individuals with complex psychiatric conditions, highlighting the potential life-threatening consequences of polypharmacy in this population.

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Section: Discussionmentioning

confidence: 99%