OBJECTIVE: Clozapine, a dibenzodiazepine antipsychotic, is the most effective medication for treatment-resistant schizophrenia. However, its use has been limited by the high risk of neutropenia. In children, the rate of neutropenia is higher when compared to adults. We decided to explore the use of lithium to manage neutropenia in childhood-onset schizophrenia (COS) through a systematic audit of COS cases. METHODS: Medical records were reviewed for patients with COS who had been treated with the combination of clozapine and lithium carbonate. RESULTS: Seven patients were found to have been treated with both clozapine and lithium. After initiation of lithium, ANC increased significantly in six out of seven subjects by 29 to 106% with a mean of 66%. In addition, six out of seven subjects continued using both clozapine and lithium for over 2 years (range: 2.0-7.2 years) and do not have immediate plans for discontinuation of either medications. CONCLUSIONS: Our study bolsters support for the use of lithium in the management of neutropenia in children treated with clozapine. Although the coadministration of lithium and clozapine appears effective in the management of neutropenia, it is not without its risks and clinicians must be diligent in their joint use of these medications.
OBJECTIVE:Clozapine, a dibenzodiazepine antipsychotic, is the most effective medication for treatment-resistant schizophrenia. However, its use has been limited by the high risk of neutropenia. In children, the rate of neutropenia is higher when compared to adults. We decided to explore the use of lithium to manage neutropenia in childhood-onset schizophrenia (COS) through a systematic audit of COS cases. METHODS: Medical records were reviewed for patients with COS who had been treated with the combination of clozapine and lithium carbonate. RESULTS: Seven patients were found to have been treated with both clozapine and lithium. After initiation of lithium, ANC increased significantly in six out of seven subjects by 29 to 106% with a mean of 66%. In addition, six out of seven subjects continued using both clozapine and lithium for over 2 years (range: 2.0-7.2 years) and do not have immediate plans for discontinuation of either medications. CONCLUSIONS: Our study bolsters support for the use of lithium in the management of neutropenia in children treated with clozapine. Although the coadministration of lithium and clozapine appears effective in the management of neutropenia, it is not without its risks and clinicians must be diligent in their joint use of these medications.
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Authors: Sanjiv Kumra; Harvey Kranzler; Ginny Gerbino-Rosen; Hana M Kester; Courtney De Thomas; Vivian Kafantaris; Christoph U Correll; John M Kane Journal: Biol Psychiatry Date: 2007-07-25 Impact factor: 13.382
Authors: Joseph P McEvoy; Jeffrey A Lieberman; T Scott Stroup; Sonia M Davis; Herbert Y Meltzer; Robert A Rosenheck; Marvin S Swartz; Diana O Perkins; Richard S E Keefe; Clarence E Davis; Joanne Severe; John K Hsiao Journal: Am J Psychiatry Date: 2006-04 Impact factor: 19.242
Authors: Kristin N Maher; Marcus Tan; Julia W Tossell; Brian Weisinger; Peter Gochman; Rachel Miller; Deanna Greenstein; Gerald P Overman; Judith L Rapoport; Nitin Gogtay Journal: J Child Adolesc Psychopharmacol Date: 2013-03 Impact factor: 2.576
Authors: Richard C McEachin; Haiming Chen; Maureen A Sartor; Scott F Saccone; Benjamin J Keller; Alan R Prossin; James D Cavalcoli; Melvin G McInnis Journal: BMC Syst Biol Date: 2010-11-19