Severe Leukopenia With Valproate

Neutropenia and Leukopenia After Cross Taper From Quetiapine to Divalproex for the Treatment of Borderline Personality Disorder

“…1,2 Neutropenia and leukopenia have been reported in isolated cases, most occurring in pediatric patients or patients with epilepsy. [3][4][5][6][7][8][9][10][11][12][13][14] Several case reports of DVP-related neutropenia (absolute neutrophil count [ANC] < 1.50 10 3 /mcL) and leukopenia (white blood cell count [WBC] < 4.0 10 3 /mcL) were reviewed during our literature search, some caused by DVP monotherapy; others were thought to be related to concomitant use of DVP and another drug. [15][16][17][18][19][20][21][22][23][24][25] Quetiapine was the antipsychotic most commonly implicated in causing hematologic abnormalities when combined with DVP.…”

Novel use of granulocyte colony stimulating factor as an adjunct for treatment of schizoaffective disorder complicated by sodium valproate induced agranulocytosis

“…[2] Although the etiology for this is unclear, immune-mediated destruction and toxic effects on the bone marrow are considered to play a potential role. The onset of agranulocytosis can be variable ranging from a few days[2] to a month[3] with mortality rates up to 16%. [4] A recombinant form of granulocyte colony-stimulating factor (G-CSF), a glycoprotein which stimulates the bone marrow to produce granulocyte and stem cells, is currently in use for the treatment of agranulocytosis.…”