Clozapine-induced agranulocytosis and thrombopenia in a patient with dopaminergic psychosis

Rudolf, Jobst; Grond, Martin; Neveling, M.; Heiss, Wolf Dieter

doi:10.1007/bf01294731

Cited by 26 publications

(7 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 Although the exact mechanism is not known, clozapine, an atypical antipsychotic, does have noted serotonergic properties. 9 Although rare, clozapine-induced agranulocytosis has been noted in 1-2% of patients receiving the medication. Although the relationship between clozapine and SSRIs is not fully understood, hematologic effects with SSRIs cannot be ruled out.…”

Section: Discussionmentioning

confidence: 99%

Leukopenia Associated with Paroxetine Use

Trewet

Galioto

Payne

2007

Journal of Pharmacy Technology

View full text Add to dashboard Cite

Objective: To report a case of leukopenia associated with paroxetine treatment. Case Summary: A 44-year-old white female with a history of anemia secondary to heavy menses, anxiety, depression, and current tobacco dependence presented with general symptoms of fatigue and blurred vision. The patient's medications at the time of the initial visit were ferrous sulfate 325 mg twice a day and paroxetine 20 mg/day. Three years prior to the initiation of paroxetine, the patient's documented white blood cell (WBC) count was 7.4 × 103/μL with normal differential and hemoglobin was 10.5 g/dL; on presentation, laboratory test results were WBC count 1.3 × 103/μL, red blood cell count 1.78 × 106/μL, hemoglobin 4.5 g/dL, hematocrit 15.1%, and platelets 248 × 103/μL. Three months after discontinuation of paroxetine, the patient's WBC count was 4.4 × 103/μL. Discussion: Paroxetine and other antidepressants have not been known to cause adverse hematologic effects that can be seen with other antipsychotics, namely, clozapine. The use of the Naranjo probability scale indicated a probable relationship between leukopenia and paroxetine therapy in this patient. Based on a MEDLINE search (February 12, 2007), there are limited data on leukopenia as an adverse event of paroxetine. We found this to be a unique case of leukopenia suspected to be secondary to extended use of low-dose paroxetine. Conclusions: Although leukopenia caused by paroxetine and other medications with serotonergic effects appears to be uncommon, physicians and pharmacists should be aware of this rare but potentially serious adverse event.

show abstract

Section: Discussionmentioning

confidence: 99%

Leukopenia Associated with Paroxetine Use

Trewet

Galioto

Payne

2007

Journal of Pharmacy Technology

View full text Add to dashboard Cite

show abstract

“…Clozaril has high affinity for the D4 dopamine receptor. It also blocks D1 dopamine receptors in the limbic system and has antihistaminic (greatest affinity), antimuscarinic, antiadrenergic, and antiserotinergic effects (Rudolf, Grond, Neveling, & Heiss, 1997). Clozapine, widely regarded as the most effacious therapy for the treatment of schizophrenia, has been shown to produce a sigruficant improvement in 30% to 60% of schizophrenic patients unresponsive to traditional antipsychotics.…”

Section: Clozapine-induced Agranulocytosismentioning

confidence: 99%

Biological Perspectives

Wren

Frizzell

Keltner

et al. 2008

Perspectives in Psychiatric Care

View full text Add to dashboard Cite

“…As a consequence, atypical antipsychotics have been introduced for the treatment of DIP [37]. Clozapine has no extrapyramidal side effects, but can produce marked leukopenia [17,26,30,33]. Risperidone and olanzapine, although atypical antipsychotics, can produce extrapyramidal side effects, and in addition, olanzapine induces weight gain [12,15,23,29].…”

Section: Introductionmentioning

confidence: 99%