Psychopharmacology

, Volume 124, Issue 1–2, pp 201–204 | Cite as

Does eosinophilia predict clozapine induced neutropenia?

  • M. Hummer
  • B. Sperner-Unterweger
  • M. Kurz
  • W. W. Fleischhacker
  • M. Falk
  • G. Kemmler
  • H. Oberbauer
Original Investigation

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.

Key words

Clozapine Haloperidol Eosinophilia Neutropenia Agranulocytosis 

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References

  1. 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]:10–16Google Scholar
  2. Alvir JMJ, Lieberman JA, Safferman AZ, Schwimmer JL, Schaaf JA (1993) Clozapine-induced agranulocytosis. N Engl J Med 329:162–167Google Scholar
  3. Banov MD, Tohen M, Friedberg J (1993) High risk of eosinophilia in women treated with clozapine. J Clin Psychiatry 54:466–469Google Scholar
  4. Bender JE, Van Epps DE, Stewart CC (1987) Regulation of myelopoiesis. Comp Immunol Microbiol Infect Dis 10:79–91Google Scholar
  5. 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]:3–6Google Scholar
  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 40:846–853Google Scholar
  7. Frankenburg FR, Kando J (1992) Eosinophilia, clozapine, and pancreatitis. Lancet 340:251Google Scholar
  8. Gerson SL, Meltzer J (1992) Mechanisms of clozapine-induced agranulocytosis. Drug Safety 7 [Suppl 1]:17–25Google Scholar
  9. Hoffbrand AV (1992a). Concluding remarks. Drug Safety 7 [Suppl 1):60Google Scholar
  10. Hoffbrand AV (1992b) Round-table discussion. Drug Safety (Suppl 1):57–59Google Scholar
  11. Hummer M, Kurz M, Barnas C, Fleischhacker WW (1992) Transient neutropenia induced by clozapine. Psychopharmacol Bull 28:287–290Google Scholar
  12. Hummer M, Kurz M, Barnas C, Saria A, Fleischhacker WW (1994) Clozapine-induced transient white blood count disorders. J Clin Psychiatry 55:429–432Google Scholar
  13. Krupp P, Barnes P (1992) Clozapine-associated agranulocytosis: risk and aetiology. Br J Psychiatry 160 [Suppl 17]:38–40Google Scholar
  14. 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 49:271–277Google Scholar
  15. 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 53:242–244Google Scholar
  16. 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]:33–44Google Scholar
  17. Pisciotta AV, Konings SA, Ciesemier LL et al. (1992) Cytotoxic activity in serum of patients with clozapine-induced agranulocytosis. J Lab Clin Med 119:254–266Google Scholar
  18. Ruef C, Coleman DL (1991) GM-CSF and G-CSF: Zytokine in der klinischen Anwendung. Schweiz Med Wschr 121:397–412Google Scholar
  19. Safferman AZ, Lieberman JA, Alvir JMJ, Howard A (1992) Rechallenge in clozapine-induced agranulocytosis. Lancet 339:1296–1297Google Scholar
  20. Steel RGD, Torrie JH (1981) Principles and procedures of statistics — a biometrical approach. McGraw Hill, London, pp 280–282Google Scholar
  21. Stricker BH, Tielens JAE (1991) Eosinophilia with clozapine. Lancet 338:1520–1521Google Scholar
  22. Tiihonen J, Paanila J (1992) Eosinophilia associated with clozapine. Lancet 339:488Google Scholar
  23. 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):26–32Google Scholar
  24. Yunis JJ, Lieberman J, Yunis EJ (1992) Major histocompatibility complex associations with clozapine-induced agranulocytosis: the USA experience. Drug Safety 7 [Suppl 1):7–9Google Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • M. Hummer
    • 1
  • B. Sperner-Unterweger
    • 1
  • M. Kurz
    • 1
  • W. W. Fleischhacker
    • 1
  • M. Falk
    • 2
  • G. Kemmler
    • 3
  • H. Oberbauer
    • 3
  1. 1.Department of Biological PsychiatryInnsbruck University ClinicsInnsbruckAustria
  2. 2.Department of BiostatiticsInnsbruck UniversityA-InnsbruckAustria
  3. 3.Department of General PsychiatryInnsbruck University ClinicsInnsbruckAustria

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