P0329 - Carbamazepine induced bicytopenia, three years later- case report

Abstract

Carbamazepine was the first anticonvulsant widely used in psychiatry, first for the treatment of bipolar disorder and later for other psychotic disorder (adjunctive). Some of the side effects, which usually occur at the beginning of the therapy with this medicament, are hematological changes which consider transitory leucopenia (10%), persistent leucopenia (2%) and rarely thrombocytopenia. Just these side effects were registered in patient described in this paper.

26 year old men diagnosed as schizophrenia (according to ICD X criteria) was administrated carbamazepine as adjuvant therapy because difficulties in behavior control, seven years ago in dosage of 400mg daily. After four years of therapy, on routine complete blood count (CBC) checking decreased number of white blood cells (2.9 white cells/mm3) and platelets (110000/mm3) were registered. Carbamazepine was excluded from therapy immediately, and from that time on patient is under a regular control of hematologist who diagnosed Bicytopenia (Leucopenia and Thrombocytopenia) and prescribed multivitamin therapy. After three years of these changes, CBC normalized. This entire time patient did not have any symptom which could consider immunological trouble or problem with blood coagulation.