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Combination of strategies to initiate clozapine for refractory schizophrenia in a patient with low neutrophil levels

Clozapine is the only drug with confirmed efficacy for refractory schizophrenia; however, its use is restricted due to the risk of potentially life-threatening side effects, such as agranulocytosis. Although this restriction ensures safety against haematological risks, some patients with refractory...

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Autores principales: Takanobu, Keisuke, Hashimoto, Naoki, Ishikawa, Shuhei, Kusumi, Ichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9562318/
https://www.ncbi.nlm.nih.gov/pubmed/36229076
http://dx.doi.org/10.1136/bcr-2021-247734
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author Takanobu, Keisuke
Hashimoto, Naoki
Ishikawa, Shuhei
Kusumi, Ichiro
author_facet Takanobu, Keisuke
Hashimoto, Naoki
Ishikawa, Shuhei
Kusumi, Ichiro
author_sort Takanobu, Keisuke
collection PubMed
description Clozapine is the only drug with confirmed efficacy for refractory schizophrenia; however, its use is restricted due to the risk of potentially life-threatening side effects, such as agranulocytosis. Although this restriction ensures safety against haematological risks, some patients with refractory schizophrenia who have low neutrophil levels may miss the opportunity to receive clozapine treatment. We herein report the case of a patient with refractory schizophrenia and low neutrophil levels who was successfully initiated on clozapine treatment after the use of several methods for increasing neutrophil levels. These strategies consisted of discontinuation of antipsychotics, treatment with lithium carbonate and adenine, and light exercise before blood testing. Combining these procedures may be an effective option in the treatment of patients with refractory schizophrenia whose neutrophil levels are not sufficient to initiate clozapine.
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spelling pubmed-95623182022-10-15 Combination of strategies to initiate clozapine for refractory schizophrenia in a patient with low neutrophil levels Takanobu, Keisuke Hashimoto, Naoki Ishikawa, Shuhei Kusumi, Ichiro BMJ Case Rep Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation) Clozapine is the only drug with confirmed efficacy for refractory schizophrenia; however, its use is restricted due to the risk of potentially life-threatening side effects, such as agranulocytosis. Although this restriction ensures safety against haematological risks, some patients with refractory schizophrenia who have low neutrophil levels may miss the opportunity to receive clozapine treatment. We herein report the case of a patient with refractory schizophrenia and low neutrophil levels who was successfully initiated on clozapine treatment after the use of several methods for increasing neutrophil levels. These strategies consisted of discontinuation of antipsychotics, treatment with lithium carbonate and adenine, and light exercise before blood testing. Combining these procedures may be an effective option in the treatment of patients with refractory schizophrenia whose neutrophil levels are not sufficient to initiate clozapine. BMJ Publishing Group 2022-10-13 /pmc/articles/PMC9562318/ /pubmed/36229076 http://dx.doi.org/10.1136/bcr-2021-247734 Text en © BMJ Publishing Group Limited 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
Takanobu, Keisuke
Hashimoto, Naoki
Ishikawa, Shuhei
Kusumi, Ichiro
Combination of strategies to initiate clozapine for refractory schizophrenia in a patient with low neutrophil levels
title Combination of strategies to initiate clozapine for refractory schizophrenia in a patient with low neutrophil levels
title_full Combination of strategies to initiate clozapine for refractory schizophrenia in a patient with low neutrophil levels
title_fullStr Combination of strategies to initiate clozapine for refractory schizophrenia in a patient with low neutrophil levels
title_full_unstemmed Combination of strategies to initiate clozapine for refractory schizophrenia in a patient with low neutrophil levels
title_short Combination of strategies to initiate clozapine for refractory schizophrenia in a patient with low neutrophil levels
title_sort combination of strategies to initiate clozapine for refractory schizophrenia in a patient with low neutrophil levels
topic Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9562318/
https://www.ncbi.nlm.nih.gov/pubmed/36229076
http://dx.doi.org/10.1136/bcr-2021-247734
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