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Neutropenia and Agranulocytosis in Patients Receiving Clozapine in the UK and Ireland

Published online by Cambridge University Press:  02 January 2018

Karen Atkin ,
Francis Kendall ,
Duncan Gould ,
Hugh Freeman ,
Jeffrey Lieberman  and
Desmond O'Sullivan
Karen Atkin*
Affiliation:
Clozaril Patient Monitoring Service, Sandoz Pharmaceuticals
Francis Kendall
Affiliation:
Sandoz Pharmaceuticals
Duncan Gould
Affiliation:
Sandoz Pharmaceuticals
Jeffrey Lieberman
Affiliation:
Albert Einstein College of Medicine, New York
Desmond O'Sullivan
Affiliation:
Sandoz Pharmaceuticals
*
Dr Karen J. Atkin, Senior Medical Adviser in Pharmacovigilance, Clozaril Patient Monitoring Service, Sandoz Pharmaceuticals, Frimley Business Park, Frimley, Surrey GU16 5SG
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Abstract

Background

Clozapine can cause reversible agranulocytosis and neutropenia. This study documents the occurrence of blood dyscrasias and identifies predisposing risk factors.

Method

An analysis was made of the haematological, demographic, and dosage data from a central database on 6316 patients receiving clozapine over four and a half years in the UK and Ireland.

Results

During the study period 2.9% of the patients developed neutropenia and 0.8% developed agranulocytosis. The peak incidence of both disorders was in the first 6–18 weeks of treatment. Fatal agranulocytosis occurred in 0.03% of patients. After the first year of treatment the incidence of agranulocytosis significantly decreased to the order noted with some phenothiazines.

Conclusions

The use of a patient monitoring service kept the haematological risks associated with using clozapine within acceptable limits, particularly in view of the benefits of this medication in treatment-resistant schizophrenia.

Type
Papers
Information
The British Journal of Psychiatry , Volume 169 , Issue 4 , October 1996 , pp. 483 - 488
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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