Clozapine Induced Neutropenia In Patients Suffering From Schizophrenia : A Multi Centre Audit

Article Title: Clozapine Induced Neutropenia In Patients Suffering From Schizophrenia : A Multi Centre Audit

Author(s): Munir Hamirani , Asghar Naqvi, M Shehzad Saleem , Intisar Ahmad Siddiqui

Institute(s): Department of Psychiatry Abbasi Shaheed Hospital Karachi Medical & Dental College; Novartis Pharma Pakistan Limited

Journal: Journal of Pakistan Psychiatric Society, 2006, Vol. 3, No. 1, p. 39–42


Objective: To determine the frequency of clozapine induced neutropenia and its associated clinical features among the patients suffering from schizophrenia.

Design: Cross sectional, comparative

Place and duration of study: The study is based on the blood count reports from various centres in Pakistan using Clozapine during a period 1992-2005.

Subjects and Methods: The medical records of 917 patients with a diagnosis of schizophrenia, aged 18 years and above were reviewed. Patient’s profile was evaluated consisting of gender, dose of clozapine, duration of treatment and complete blood count (CBC) findings including white blood cell (WBC) count or absolute neutrophil count (ANC), before starting the treatment. The case records showing WBC count below 3000 and ANC count less than 500 were identified and details of the clinical and sociodemographic variables were recorded on a proforma.

Results: Thirty eight patients (4.1%) developed clozapine induced neutropenia. Median duration of clozapine treatment in these patients was 6.0 years that was significantly higher than Median = 1 year of those patients who did not develope neutropenia (p < 0.001). An inverse correlation (r = -0.046) was observed between ANC and duration of clozapine induction. Median dose (mg) of clozapine induced neutropenia patients was higher (200 vs. 150, p = 0.262), however statistically insignificant.

Conclusion: The incidence of clozapine induced neutropenia of our study is comparable with that of worldwide reported incidence. Prolongation of treatment also increase the incidence.

Key words: Schizophrenia, Clozapine, Neutropenia.

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