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Continuing Clozapine Despite Neutropenia

Published online by Cambridge University Press:  02 January 2018

Michael L. Wesson ,
David M. Finnegan  and
Peter I. Clark
Michael L. Wesson*
Affiliation:
Scott Clinic, Regional Secure Unit, Merseyside
David M. Finnegan
Affiliation:
Scott Clinic, Regional Secure Unit, Merseyside
Peter I. Clark
Affiliation:
Department of Medical Oncology, Clatterbridge Hospital, Bebington, Wirral, Merseyside
*
Michael L. Wesson, Mossley House, Mossley Hill Hospital, Park Avenue, Mossley Hill, Liverpool L18 8BU
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Abstract

Background

A 40-year-old chronic schizophrenic patient whose psychosis and associated violent behaviour resolved on clozapine, required chemotherapy for a testicular teratoma with pulmonary metastases. His treatment was initially delayed due to refusal to consent.

Treatment

The patient finally agreed to orchidectomy and cytotoxic therapy, and following agreement by the CPMS, clozapine continued to be dispensed despite neutropenia and ‘red alert’ status on full blood count.

Discussion

This is the only patient to continue clozapine despite ‘red alert’ status, and as such is an exceptional case, but may open the way for such patients in the future.

Type
Papers
Information
The British Journal of Psychiatry , Volume 168 , Issue 2 , February 1996 , pp. 217 - 220
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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References

Alvir, J. M. J., Lieberman, J. A., Safferman, A. Z., et al (1993) Clozapine induced agranulocytosis: incidence and risk factors in the United States. New England Journal of Medicine, 329, 162–167.CrossRefGoogle ScholarPubMed
Atkin, K. & Veys, P. (1994) Clozapine-induced neutropenia, or not (letter). British Journal of Psychiatry, 165, 407–408.CrossRefGoogle ScholarPubMed
Beer, D., Cope, S., Paton, C., et al (1994) Clozapine-induced neutropenia – or not (letter). British Journal of Psychiatry, 164, 850.CrossRefGoogle ScholarPubMed
Re C High Court of Justice (Family Division) (1993) Case number 6703/93.Google Scholar
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