Treatment of severe clozapine-induced neutropenia with granulocyte colony-stimulating factor (G-CSF). Remission despite continuous treatment with clozapine

A 17-year-old boy suffering from a severe schizophrenic disorder of the paranoid type and mental retardation did not respond to treatment with typical antipsychotics, whereas under clozapine treatment he showed a favourable response. Discontinuation of clozapine led to an acute psychotic relapse. Du...

Full description

Saved in:
Bibliographic Details
Published in:British journal of psychiatry 1998-01, Vol.172 (1), p.82-84
Main Authors: Sperner-Unterweger, B, Czeipek, I, Gaggl, S, Geissler, D, Spiel, G, Fleischhacker, WW
Format: Article
Language:English
Subjects:
Adolescent
Antipsychotic Agents - adverse effects
Antipsychotics
Blood
Clinical medicine
Clozapine
Clozapine - adverse effects
Colony-stimulating factor
Discontinued
Granulocyte colony-stimulating factor
Granulocyte Colony-Stimulating Factor - therapeutic use
Humans
Intellectual disabilities
Intellectual Disability
Leukocytes
Leukocytes (granulocytic)
Male
Neutropenia
Neutropenia - chemically induced
Neutropenia - therapy
Pathophysiology
Patients
Psychosis
Psychotropic drugs
Relapse
Schizophrenia
Schizophrenia, Paranoid - drug therapy
Severity
Suffering
Traditional medicine
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A 17-year-old boy suffering from a severe schizophrenic disorder of the paranoid type and mental retardation did not respond to treatment with typical antipsychotics, whereas under clozapine treatment he showed a favourable response. Discontinuation of clozapine led to an acute psychotic relapse. During clozapine treatment the patient developed severe neutropenia. Due to the history of unsatisfactory response to traditional antipsychotics, clozapine treatment was continued despite white blood cell (WBC) decline. Concomitant treatment with G-CSF was followed by a rapid normalisation of WBC. This case report is not intended to challenge the clinical practice of discontinuing clozapine upon the development of neutropenia/agranulocytosis, but rather to stimulate further research in the pathophysiology and clinical consequences of a clozapine rechallenge after a WBC decline, especially in patients with a rather complex symptomatology where no sufficient therapeutic results can be achieved with any other pharmacological intervention than clozapine.
ISSN:0007-1250
1472-1465
DOI:10.1192/bjp.172.1.82