- Title
- Continuation of treatment with clozapine after an episode of neutropenia
- Creator
- Tirupati, Srinivasan; Gordon, Tracy
- Relation
- Journal of Clinical Psychopharmacology Vol. 41, Issue 3, p. 320-322
- Publisher Link
- http://dx.doi.org/10.1097/JCP.0000000000001371
- Publisher
- Lippincott Williams & Wilkins
- Resource Type
- journal article
- Date
- 2021
- Description
- Background: Clozapine is the most effective in treatment-resistant schizophrenia. Neutropenia is an adverse effect of the drug requiring treatment discontinuation. This study related treatment continuation with little or no interruption after a neutropenia episode. The study contrasted from rechallenge studies after an extended treatment interruption. Methods: This retrospective chart audit examined 37 patients with an episode of neutropenia. It described characteristics of patients continuing treatment with minimal interruption. Findings: Thirty-one patients continued treatment after an initial treatment interruption for less than 3 days. A probable cause for neutropenia other than clozapine was identified in 14 patients. Twelve patients continued treatment with a change in the absolute neutrophil counts threshold to 1000/μL to determine treatment cessation.Most patients recovered from the index episode of neutropenia within 2 days. They also frequently presented with recurring benign episodes of low neutrophil cell counts during treatment than a comparative group. Implications: The study recommends modifying clozapine treatment protocol absolute neutrophil count thresholds to less than 1000/μL to determine treatment cessation. Consideration of other probable causes for neutropenia, diurnal variations in cell counts, and laboratory errors reduced preemptive discontinuation of treatment. A risk-benefit approach supports continuing clozapine treatment after an episode of neutropenia.
- Subject
- schizophrenia; clozapine; neutropenia; continuation of treatment
- Identifier
- http://hdl.handle.net/1959.13/1461678
- Identifier
- uon:46272
- Identifier
- ISSN:0271-0749
- Language
- eng
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