Almaghrebi AH. Safety of a Clozapine Trial Following Quetiapine-Induced Leukopenia: A Case Report.
Curr Drug Saf 2019;
14:80-83. [PMID:
30084338 DOI:
10.2174/1574886313666180807094654]
[Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/02/2018] [Accepted: 08/03/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND
The clozapine-derivative quetiapine has been shown in some cases to cause leukopenia and neutropenia.
CASE PRESENTATION
We reported on a case of a young female diagnosed with treatment-resistant schizophrenia. After failed trials of three antipsychotic medications and despite a history of quetiapineinduced leukopenia, clozapine treatment was introduced due to the severity of the patient's symptoms, the limited effective treatment options, and a lack of guidelines on this issue.
RESULT
Over a ten-week period of clozapine treatment at 700 mg per day, the patient developed agranulocytosis. Her white blood cell count sharply dropped to 1.6 × 109 L, and her neutrophils decreased to 0.1 × 109 L. There had been no similar reaction to her previous medications (carbamazepine, risperidone, and haloperidol).
CONCLUSION
The safety of clozapine in a patient who has previously experienced leukopenia and neutropenia with quetiapine requires further investigation. Increased attention should be paid to such cases. Careful monitoring and slow titration are advisable.
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