Use of lithium in the treatment of clozapineinduced neutropenia: a case report
DOI:
https://doi.org/10.25118/2763-9037.2017.v7.105Keywords:
Clozapine, lithium, neutropeniaAbstract
Clozapine is the antipsychotic of choice for the treatment of refractory schizophrenia. Agranulocytosis, however, is a serious side effect that may limit its use. We describe the case of a 25-year old patient, hospitalized, diagnosed with refractory schizophrenia. Clozapine was initiated, with excellent response, but significant neutropenia was observed at 11 weeks of drug use, and clozapine was then discontinued. Given the seriousness of the case and the good response obtained with clozapine, lithium carbonate was used as a granulopoiesis stimulating agent. After neutrophil count normalization and stabilization, clozapine was reintroduced to the therapeutic scheme. The patient showed a good clinical response, was discharged, and has been stable since then. The case suggests the possibilities of using clozapine again in patients who have presented granulocytopenia when the associated use of lithium is possible, and of using lithium previously in patients with low leucocyte levels who are candidates for clozapine use.
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