olanzapine and Leukopenia

Topics: Antipsychotic Agents; Drug Labeling; Humans; Leukopenia; Olanzapine; Quetiapine Fumarate; Respiratory Tract Infections; Risk Factors

Leukopenia is a known hematological side effect of atypical antipsychotics. We report a case of an antipsychotic-naive patient with schizophrenia who developed leukopenia after a single dose of olanzapine, which worsened during subsequent treatment with risperidone. Normalization of the white blood cell counts occurred within 24 hours of risperidone discontinuation. Possible synergistic mechanisms underlying olanzapine-induced and risperidone-induced leukopenia are discussed. This case highlights the challenges in identifying and managing nonclozapine antipsychotic-induced leukopenia in a susceptible patient.

Topics: Antipsychotic Agents; Drug Synergism; Female; Humans; Leukopenia; Middle Aged; Olanzapine; Risperidone; Schizophrenia

Topics: Antipsychotic Agents; Benzodiazepines; Clozapine; Delayed-Action Preparations; Female; Humans; Leukopenia; Middle Aged; Neutropenia; Olanzapine; Schizophrenia

Clozapine is a well-known antipsychotic to cause fatal agranulocytosis but there are only a few case reports about the risk of leukopenia and agranulocytosis associated with other atypical antipsychotics. Olanzapine has structural pharmacological similarities to those of clozapine and reports about haematological adverse effects of olanzapine include three groups: the first group includes cases of olanzapine-induced neutropenia, the second informing that olanzapine is safe after clozapine induced agranulocytosis and the third group forms prolongation of clozapine-induced leukopenia with olanzapine use. The aim of this paper is to report a case of prolongation of clozapine-induced leukopenia despite olanzapine treatment and discuss leukopenia caused by atypical antipsychotic use in the light of recent and limited literature.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Chronic Disease; Clozapine; Humans; Leukopenia; Male; Olanzapine; Schizophrenia

Atypical antipsychotics, including olanzapine, were originally expected to reduce the risk of haematological toxicity and to be safe alternatives to clozapine. We report a case of patient who developed leucopenia and neutropenia during treatment with olanzapine.

Topics: Aged; Antipsychotic Agents; Benzodiazepines; Depressive Disorder, Major; Humans; Leukopenia; Male; Neutropenia; Olanzapine

Leukopenia and agranulocytosis are well reported and dangerous haematological side-effects associated with the use of typical and atypical antipsychotics. These potentially life-threatening phenomena have led to treatment discontinuation and the consequent reemergence of psychiatric symptoms. We report three cases of patients who developed leukopenia during olanzapine treatment. In each case, the leukopenia was dose-dependent. Reduction in the dose of olanzapine was followed by normalization of the white blood count which allowed continuation of the medication. These cases suggest the possibility that, in some patients, leukopenia or agranulocytosis during olanzapine treatment might be dose-related. Thus, olanzapine dose reduction may permit treatment continuation where this is clinically indicated. In our cases, haematological side-effects were satisfactorily controlled by dose reduction without allowing the reemergence of psychiatric symptoms. This clinical management may offer an alternative to treatment suspension. A careful monitoring of the white blood count is obviously recommended. Olanzapine may be considered a potential and safer treatment for a this specific group of patients.

Topics: Adolescent; Adult; Antipsychotic Agents; Benzodiazepines; Dose-Response Relationship, Drug; Female; Humans; Leukopenia; Male; Olanzapine; Pirenzepine; Schizophrenia

Topics: Antipsychotic Agents; Benzodiazepines; Female; Humans; Leukocyte Count; Leukopenia; Middle Aged; Olanzapine; Pirenzepine; Schizophrenia, Paranoid; Thrombocytopenia

We report a 2-year experience with olanzapine treatment (20 mg daily) in a 65-year-old male patient with treatment-resistant paranoid schizophrenia, who had previously developed leucopenia and neutropenia first on clozapine and, subsequently, also on risperidone. Olanzapine seems to be safe in this patient, since no major decreases of haematological parameters were observed. The only exception was a brief decrease of leucocyte and neutrophil (but not erythrocyte or platelet) counts during influenza-like viral infection. However, the control of psychotic symptoms on olanzapine is not as good as on clozapine.

Topics: Aged; Antipsychotic Agents; Benzodiazepines; Clozapine; Drug Monitoring; Humans; Leukopenia; Male; Neutropenia; Olanzapine; Pirenzepine; Risk Factors; Risperidone; Schizophrenia, Paranoid

Topics: Adolescent; Adult; Antipsychotic Agents; Benzodiazepines; Bone Marrow; Female; Humans; Leukocyte Count; Leukopenia; Male; Neutropenia; Olanzapine; Pirenzepine; Risk Factors; Selective Serotonin Reuptake Inhibitors

Four patients affected by severe Parkinson's disease developed leucopenia (900-1200 WBC) during treatment of psychosis (3) or untreatable insomnia (1) with clozapine (37.5-75 mg/day). Clozapine withdrawal was followed by recovery of leucopenia (4000-6000 WBC) in two weeks with no need for the administration of leucokines. After 1-6 months olanzapine was administered (increasing the dose from 2.5 to 10 mg/day) to treat persisting disturbances, but the drug induced severe worsening of parkinsonism and also this drug had to be withdrawn.

Topics: Aged; Aged, 80 and over; Antipsychotic Agents; Benzodiazepines; Clozapine; Dose-Response Relationship, Drug; Female; Hallucinations; Humans; Leukopenia; Male; Olanzapine; Parkinson Disease; Pirenzepine; Psychotic Disorders; Sexual Dysfunctions, Psychological; Sleep Initiation and Maintenance Disorders

Topics: Benzodiazepines; Female; Humans; Leukopenia; Male; Middle Aged; Olanzapine; Pirenzepine; Psychotic Disorders; Selective Serotonin Reuptake Inhibitors