Neutropenia and Agranulocytosis in Chinese Patients Prescribed Clozapine.

OBJECTIVES

To examine the rate of neutropenia and agranulocytosis, and the pattern of development of these 2 disorders among Chinese patients prescribed clozapine treatment in a local psychiatric unit.

METHODS

Patients who were receiving clozapine when they were under the care of Pamela Youde Nethersole Eastern Hospital Psychiatric Unit, Hong Kong, from 1 January 1997 to 31 December 2012 and who developed neutropenia and agranulocytosis from 1 January 1997 to 30 June 2013 were retrospectively reviewed.

RESULTS

A total of 13 patients out of 980 clozapine recipients developed neutropenia and 3 developed agranulocytosis during treatment. Half of them were aged > 50 years and three quarters were female. The majority of patients who developed neutropenia and agranulocytosis were prescribed > 1 psychotropic medication in addition to clozapine. Half of the incidents occurred in the first 18 weeks of clozapine treatment.

CONCLUSION

Long-term monitoring of white cell count is necessary during clozapine treatment. The concurrent use of clozapine with other potentially leukopenic psychotropic drugs should be limited.