Leukopenia and agranulocytosis in atypical antipsychotic treatment - besides clozapine

Introduction Leukopenia and agranulocytosis are reported and dangerous haematological side-effects associated with the use of antipsychotics, mostly reported for clozapine administration. However, increased case reports about severe abnormalities even during treatment with second generation antips...

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Main Authors: B. Jorge, C. Pedro Fernandes, J. Carvalho
Format: Article
Language:English
Published: Cambridge University Press 2021-04-01
Series:European Psychiatry
Subjects:
Online Access:https://www.cambridge.org/core/product/identifier/S092493382102112X/type/journal_article
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author B. Jorge
C. Pedro Fernandes
J. Carvalho
author_facet B. Jorge
C. Pedro Fernandes
J. Carvalho
author_sort B. Jorge
collection DOAJ
description Introduction Leukopenia and agranulocytosis are reported and dangerous haematological side-effects associated with the use of antipsychotics, mostly reported for clozapine administration. However, increased case reports about severe abnormalities even during treatment with second generation antipsychotics other than clozapine. Objectives This review aims to compare haematological abnormalities associated with clozapine vs non-clozapine antipsychotic treatment, regarding aspects such as safety levels or the need for regular blood samples monitoring. Methods Pubmed and Google Scholar were searched for eligible articles, through keyword search and cross-referencing. Results Neutropenia is common both in patients with schizophrenia on clozapine treatment and in those never on clozapine. Cases of agranulocytosis has been described with the use of olanzapine, risperidone or paliperidone, that do not have the same monitoring regulatory process as clozapine. Conclusions These results highlight the challenges in identifying and managing non-clozapine antipsychotic-induced leukopenia in susceptible patients. Continued research in this domain for evidence based management of antipsychotic-induced blood dyscrasias Disclosure No significant relationships.
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spelling doaj.art-eaa4a9d816a44608933918faf7e7ede42023-11-17T05:07:37ZengCambridge University PressEuropean Psychiatry0924-93381778-35852021-04-0164S799S79910.1192/j.eurpsy.2021.2112Leukopenia and agranulocytosis in atypical antipsychotic treatment - besides clozapineB. Jorge0C. Pedro Fernandes1J. Carvalho2Serviço De Psiquiatria, Hospital de Braga, Braga, PortugalServiço De Psiquiatria, Hospital de Braga, Braga, PortugalServiço De Psiquiatria, Hospital de Braga, Braga, Portugal Introduction Leukopenia and agranulocytosis are reported and dangerous haematological side-effects associated with the use of antipsychotics, mostly reported for clozapine administration. However, increased case reports about severe abnormalities even during treatment with second generation antipsychotics other than clozapine. Objectives This review aims to compare haematological abnormalities associated with clozapine vs non-clozapine antipsychotic treatment, regarding aspects such as safety levels or the need for regular blood samples monitoring. Methods Pubmed and Google Scholar were searched for eligible articles, through keyword search and cross-referencing. Results Neutropenia is common both in patients with schizophrenia on clozapine treatment and in those never on clozapine. Cases of agranulocytosis has been described with the use of olanzapine, risperidone or paliperidone, that do not have the same monitoring regulatory process as clozapine. Conclusions These results highlight the challenges in identifying and managing non-clozapine antipsychotic-induced leukopenia in susceptible patients. Continued research in this domain for evidence based management of antipsychotic-induced blood dyscrasias Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S092493382102112X/type/journal_articleAntipsychoticsHaematological effectsLeukopenia/agranulocytosis
spellingShingle B. Jorge
C. Pedro Fernandes
J. Carvalho
Leukopenia and agranulocytosis in atypical antipsychotic treatment - besides clozapine
European Psychiatry
Antipsychotics
Haematological effects
Leukopenia/agranulocytosis
title Leukopenia and agranulocytosis in atypical antipsychotic treatment - besides clozapine
title_full Leukopenia and agranulocytosis in atypical antipsychotic treatment - besides clozapine
title_fullStr Leukopenia and agranulocytosis in atypical antipsychotic treatment - besides clozapine
title_full_unstemmed Leukopenia and agranulocytosis in atypical antipsychotic treatment - besides clozapine
title_short Leukopenia and agranulocytosis in atypical antipsychotic treatment - besides clozapine
title_sort leukopenia and agranulocytosis in atypical antipsychotic treatment besides clozapine
topic Antipsychotics
Haematological effects
Leukopenia/agranulocytosis
url https://www.cambridge.org/core/product/identifier/S092493382102112X/type/journal_article
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AT cpedrofernandes leukopeniaandagranulocytosisinatypicalantipsychotictreatmentbesidesclozapine
AT jcarvalho leukopeniaandagranulocytosisinatypicalantipsychotictreatmentbesidesclozapine