Why does clozapine cause neutropenia?
The exact mechanism of clozapine induced agranulocytosis is unclear. It has been postulated that clozapine is metabolised to a nitrenium ion. The binding of this ion to neutrophils may result in agranulocytosis. Antineutrophil antibodies may be involved in mediating agranulocytosis.
How does clozapine affect neutrophils?
We have previously shown that treatment of rabbits with clozapine also causes an early release of neutrophils. Clozapine is oxidized to a reactive nitrenium ion that covalently binds to neutrophils, and this reactive metabolite may be responsible for the observed effects.
How is clozapine induced neutropenia treated?
While there is no FDA approved treatment for clozapine induced agranulocytosis, pharmacologic methods have been utilized in clinical practice. These include lithium and granulocyte colony stimulating factor.
What is severe neutropenia?
Severe chronic neutropenia (SCN) is a rare blood disorder characterized by abnormally low levels of certain white blood cells (neutrophils) in the bloodstream (neutropenia) not explained by medication use, infections or another underlying health condition like blood cancers or systemic autoimmune diseases associated …
What do you need to know about clozapine neutropenia?
Absolute neutrophil count (ANC) is the laboratory parameter for monitoring patients for clozapine-induced neutropenia. Prescribers must submit the ANC before starting and during clozapine treatment.
What are the side effects of taking clozapine?
Clozapine can cause severe neutropenia, which can lead to serious infections and death. Severe neutropenia occurs in a small percentage of patients taking clozapine.
When to interrupt Clozaril for fever or neutropenia?
General Guidelines for Management of All Patients with Fever or with Neutropenia Fever: Interrupt Clozaril as a precautionary measure in any patient who develops fever, defined as a temperature of 38.5°C [101.3°F] or greater, and obtain an ANC level. Fever is often the first sign of neutropenic infection.
What are the side effects of Clozaril in schizophrenia?
Metabolic Changes. In a pooled data analysis of 2 studies in adult subjects with schizophrenia, Clozaril treatment was associated with increases in fasting serum triglyceride. The mean increase in fasting triglyceride was 71 mg/dL (54%) in the Clozaril group and 39 mg/dL (35%) in the chlorpromazine group (Table 5).