Abstract
The atypical antipsychotic clozapine carries a high risk of inducing agranulocytosis. We attempted to investigate whether eosinophilia during clozapine treatment has predictive value for subsequent neutropenia/agranulocytosis. One hundred and seventy-seven patients were studied in a prospective naturalistic design using haloperidol as the reference compound. Clozapine was found to differ from haloperidol in respect to their influence on neutrophil granulocytes. In the clozapine group patients with eosinophilia showed a decrease in neutrophil count (less than 2000/mm3 neutrophil granulocytes) significantly more often than patients without eosinophilia.
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References
Abt K, Gülich A, Krupp P, Reinberg W (1992) HLA-association in Leponex/Clozaril (clozapine)-induced granulocytopenia and agranulocytosis: statistical viewpoints. Drug Safety [suppl 1]:10–16
Alvir JMJ, Lieberman JA, Safferman AZ, Schwimmer JL, Schaaf JA (1993) Clozapine-induced agranulocytosis. N Engl J Med 329:162–167
Banov MD, Tohen M, Friedberg J (1993) High risk of eosinophilia in women treated with clozapine. J Clin Psychiatry 54:466–469
Bender JE, Van Epps DE, Stewart CC (1987) Regulation of myelopoiesis. Comp Immunol Microbiol Infect Dis 10:79–91
Claas FHJ, Abbott PA, Witvliet MD, D'Amaro J, Barnes PM, Krupp P (1992) No direct clinical relevance of the human leucocyte antigen (HLA) system in clozapine-induced agranulocytosis. Drug Safety 7 [Suppl 1]:3–6
Fischer V, Haar JA, Greiner L, Loyd RV, Mason RP (1991) Possible role of free radical formation in clozapine (Clozaril)-induced agranulocytosis. Mol Pharmacol 40:846–853
Frankenburg FR, Kando J (1992) Eosinophilia, clozapine, and pancreatitis. Lancet 340:251
Gerson SL, Meltzer J (1992) Mechanisms of clozapine-induced agranulocytosis. Drug Safety 7 [Suppl 1]:17–25
Hoffbrand AV (1992a). Concluding remarks. Drug Safety 7 [Suppl 1):60
Hoffbrand AV (1992b) Round-table discussion. Drug Safety (Suppl 1):57–59
Hummer M, Kurz M, Barnas C, Fleischhacker WW (1992) Transient neutropenia induced by clozapine. Psychopharmacol Bull 28:287–290
Hummer M, Kurz M, Barnas C, Saria A, Fleischhacker WW (1994) Clozapine-induced transient white blood count disorders. J Clin Psychiatry 55:429–432
Krupp P, Barnes P (1992) Clozapine-associated agranulocytosis: risk and aetiology. Br J Psychiatry 160 [Suppl 17]:38–40
Lieberman JA, Johns CA, Kane JM, Rai K, Pisciotta AV, Saltz BL, Howard A (1988) Clozapine-induced agranulocytosis: noncross reactivity with other psychotropic drugs. J Clin Psychiatry 49:271–277
Pfister GM, Hanson DR, Roerig JL, Landbloom R, Popkin MK (1992) Clozapine-induced agranulocytosis in a native American: HLA typing and further support for an immune-mediated mechanism. J Clin Psychiatry 53:242–244
Pisciotta AV, Konings SA, Ciesemier LL, Cronkite CE, Lieberman JA (1992) On the possible mechanisms and predictability of clozapine-induced agranulocytosis. Drug Safety 7 [Suppl 1]:33–44
Pisciotta AV, Konings SA, Ciesemier LL et al. (1992) Cytotoxic activity in serum of patients with clozapine-induced agranulocytosis. J Lab Clin Med 119:254–266
Ruef C, Coleman DL (1991) GM-CSF and G-CSF: Zytokine in der klinischen Anwendung. Schweiz Med Wschr 121:397–412
Safferman AZ, Lieberman JA, Alvir JMJ, Howard A (1992) Rechallenge in clozapine-induced agranulocytosis. Lancet 339:1296–1297
Steel RGD, Torrie JH (1981) Principles and procedures of statistics — a biometrical approach. McGraw Hill, London, pp 280–282
Stricker BH, Tielens JAE (1991) Eosinophilia with clozapine. Lancet 338:1520–1521
Tiihonen J, Paanila J (1992) Eosinophilia associated with clozapine. Lancet 339:488
Veys PA, Wilkes S, Shah S, Noyelle R, Hoffbrand AV (1992) Clinical experience of clozapine-induced neutropenia in UK: laboratory investigation using liquid culture systems and immunofluorocytometry. Drug Safety 7 [Suppl 1):26–32
Yunis JJ, Lieberman J, Yunis EJ (1992) Major histocompatibility complex associations with clozapine-induced agranulocytosis: the USA experience. Drug Safety 7 [Suppl 1):7–9
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Hummer, M., Sperner-Unterweger, B., Kurz, M. et al. Does eosinophilia predict clozapine induced neutropenia?. Psychopharmacology 124, 201–204 (1996). https://doi.org/10.1007/BF02245622
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DOI: https://doi.org/10.1007/BF02245622