Sandeep Grover1, Anish Shouan2, Subho Chakrabarti2, Ajit Avasthi2. 1. Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India. Electronic address: drsandeepg2002@yahoo.com. 2. Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Abstract
OBJECTIVE: To evaluate the incidence of clozapine induced haematological side effects among patients receiving clozapine. METHODS: Data of 333 patients who were on clozapine for a mean duration of 52.96 (45.18) months were reviewed for haematological abnormalities. RESULTS: Most of the patients (n = 320; 96.1 %) were diagnosed with psychotic disorders, mainly schizophrenia. These patients were receiving clozapine in the dose range of 12.5 mg-600 mg/day, with a mean dose of 212.08 (102.43) mg/day at the time of review of their records. About one-tenth (N = 33; 9.9 %) of patients developed eosinophilia (absolute eosinophil count >600), and 8.2 % (N = 27) experienced thrombocytopenia (platelet count <100,000 cmm3) and 7 patients developed anaemia (haemoglobin level <10 gm%). Only 2 (0.6%) patients developed neutropenia. Mean dose (mg/day) at which haematological side-effects occurred were as follows: 159.85 (87.65) mg/day for eosinophilia; 193.98 (148.93) mg/day for thrombocytopenia; 78.57 (22.49) mg/day for anaemia. In a small proportion of patients, clozapine was discontinued due to the haematological abnormalities and in other patients these abnormalities normalized on its own in subsequent follow-up. CONCLUSION: Clozapine is associated eosinophilia and thrombocytopenia, which are often benign and in majority of the patients these normalize with time.
OBJECTIVE: To evaluate the incidence of clozapine induced haematological side effects among patients receiving clozapine. METHODS: Data of 333 patients who were on clozapine for a mean duration of 52.96 (45.18) months were reviewed for haematological abnormalities. RESULTS: Most of the patients (n = 320; 96.1 %) were diagnosed with psychotic disorders, mainly schizophrenia. These patients were receiving clozapine in the dose range of 12.5 mg-600 mg/day, with a mean dose of 212.08 (102.43) mg/day at the time of review of their records. About one-tenth (N = 33; 9.9 %) of patients developed eosinophilia (absolute eosinophil count >600), and 8.2 % (N = 27) experienced thrombocytopenia (platelet count <100,000 cmm3) and 7 patients developed anaemia (haemoglobin level <10 gm%). Only 2 (0.6%) patients developed neutropenia. Mean dose (mg/day) at which haematological side-effects occurred were as follows: 159.85 (87.65) mg/day for eosinophilia; 193.98 (148.93) mg/day for thrombocytopenia; 78.57 (22.49) mg/day for anaemia. In a small proportion of patients, clozapine was discontinued due to the haematological abnormalities and in other patients these abnormalities normalized on its own in subsequent follow-up. CONCLUSION:Clozapine is associated eosinophilia and thrombocytopenia, which are often benign and in majority of the patients these normalize with time.