Closure beyond clozapine: successfully averting rebound symptoms in a patient with schizoaffective disorder and agranulocytosis

SUMMARY: ‘Rebound’ or ‘withdrawal’ symptoms are frequently observed after a sudden discontinuation of clozapine. We describe a patient with treatment-resistant schizoaffective disorder who developed agranulocytosis on clozapine but was successfully switched to treatment with olanzapine with no deter...

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Detalles Bibliográficos
Autores principales: Green, Alastair, Stephenson, Thomas, Whiskey, Eromona, Shergill, Sukhi S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2019
Materias:
Papers
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537554/
https://www.ncbi.nlm.nih.gov/pubmed/31530315
http://dx.doi.org/10.1192/bjo.2019.31
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author Green, Alastair
Stephenson, Thomas
Whiskey, Eromona
Shergill, Sukhi S.
author_facet Green, Alastair
Stephenson, Thomas
Whiskey, Eromona
Shergill, Sukhi S.
author_sort Green, Alastair
collection PubMed
description SUMMARY: ‘Rebound’ or ‘withdrawal’ symptoms are frequently observed after a sudden discontinuation of clozapine. We describe a patient with treatment-resistant schizoaffective disorder who developed agranulocytosis on clozapine but was successfully switched to treatment with olanzapine with no deterioration in her condition. We put forward three possible theories which may have accounted for the lack of rebound symptoms in this patient: the pharmacological profile of olanzapine, the anticholinergic effects of hyoscine hydrobromide, and the possibility that this patient may not be treatment-resistant and so have a reduced risk of rebound psychosis due to displaying a different pathophysiology. DECLARATION OF INTEREST: None.
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spelling pubmed-65375542019-06-10 Closure beyond clozapine: successfully averting rebound symptoms in a patient with schizoaffective disorder and agranulocytosis Green, Alastair Stephenson, Thomas Whiskey, Eromona Shergill, Sukhi S. BJPsych Open Papers SUMMARY: ‘Rebound’ or ‘withdrawal’ symptoms are frequently observed after a sudden discontinuation of clozapine. We describe a patient with treatment-resistant schizoaffective disorder who developed agranulocytosis on clozapine but was successfully switched to treatment with olanzapine with no deterioration in her condition. We put forward three possible theories which may have accounted for the lack of rebound symptoms in this patient: the pharmacological profile of olanzapine, the anticholinergic effects of hyoscine hydrobromide, and the possibility that this patient may not be treatment-resistant and so have a reduced risk of rebound psychosis due to displaying a different pathophysiology. DECLARATION OF INTEREST: None. Cambridge University Press 2019-05-22 /pmc/articles/PMC6537554/ /pubmed/31530315 http://dx.doi.org/10.1192/bjo.2019.31 Text en © The Royal College of Psychiatrists 2019 http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
spellingShingle Papers
Green, Alastair
Stephenson, Thomas
Whiskey, Eromona
Shergill, Sukhi S.
Closure beyond clozapine: successfully averting rebound symptoms in a patient with schizoaffective disorder and agranulocytosis
title Closure beyond clozapine: successfully averting rebound symptoms in a patient with schizoaffective disorder and agranulocytosis
title_full Closure beyond clozapine: successfully averting rebound symptoms in a patient with schizoaffective disorder and agranulocytosis
title_fullStr Closure beyond clozapine: successfully averting rebound symptoms in a patient with schizoaffective disorder and agranulocytosis
title_full_unstemmed Closure beyond clozapine: successfully averting rebound symptoms in a patient with schizoaffective disorder and agranulocytosis
title_short Closure beyond clozapine: successfully averting rebound symptoms in a patient with schizoaffective disorder and agranulocytosis
title_sort closure beyond clozapine: successfully averting rebound symptoms in a patient with schizoaffective disorder and agranulocytosis
topic Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537554/
https://www.ncbi.nlm.nih.gov/pubmed/31530315
http://dx.doi.org/10.1192/bjo.2019.31
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