Incidence of clozapine-induced hematological side effects in a Tunisian population

INTRODUCTION: Clozapine is commonly associated with adverse hematological outcomes. However, incidence of blood dyscrasias in the north African population is scarce. OBJECTIVES: The aim of this study was to assess the incidence of hematological side effects in a Tunisian sample of clozapine treated patients. METHODS: We conducted a retrospective longitudinal chart review of 64 patients on clozapine enrolled in our clozapine consultation between January 1, 2000 and September 2020. RESULTS: Our sample consisted of 15 women (23.5%) and 49 men (76.5%), mean age was 41.34 ±9.32 years. Patients were diagnosed with schizophrenia in 70.3% of the cases, 7 (10.9%) had a bipolar disorder and 12 (18.8%) had a schizoaffective disorder.We found blood dyscrasias in 21 patients (32.8%). Hematological abnormalities were as follow: 2 cases of agranulocytosis, 8 cases of neutropenia, 13 cases of thrombocytopenia, 5 cases of leukocytosis, 5 cases of eosinophilia and 3 cases of anemia. The incidence rate of hematological side effects was 0.1 case/year- person. The mean clozapine dose at the time of onset of the hematological side effect was 309.52 mg/day(range 25-600 mg/day).The median duration of clozapine treatment prior to developing hematological side effects was 119.71±126.52 days.Clozapine discontinuation was decided in 11 cases due to hematological side effects and reintroduced in 9 cases after normalization of blood count. CONCLUSIONS: This study emphasis on the importance of a regular long-term monitoring of blood count to ensure early detection of hematological side effects. DISCLOSURE: No significant relationships.