Acute agranulocytosis when switching from risperidone to paliperidone

Wakuda, Tomoyasu; Suzuki, Atsushi; Hasegawa, Misaki; Ichikawa, Daisuke; Yamasue, Hidenori

doi:10.1177/0004867418821441

Cited by 7 publications

(5 citation statements)

References 3 publications

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“…Monotherapy with paliperidone produced leukopenia and neutropenia (323); still, the combined use of paliperidone depot/risperidone (100-2 mg/day) resulted in leukopenia and lymphopenia but risperidone alone did not (159). Agranulocytosis was reported in a patient when switching from risperidone to paliperidone treatment (6 mg/day) (324). The treatment with paliperidone ER/valproic acid (12-1,000 mg/day) caused leukopenia and neutropenia in a patient with schizoaffective disorder (325).…”

Section: Paliperidonementioning

confidence: 99%

Immunoendocrine Peripheral Effects Induced by Atypical Antipsychotics

et al. 2020

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Atypical antipsychotics (AAP) or second-generation antipsychotics are the clinical option for schizophrenia treatment during acute psychoses, but they are also indicated for maintenance during lifetime, even though they are being used for other psychiatric conditions in clinical practice such as affective disorders and autism spectrum disorder, among others. These drugs are differentiated from typical antipsychotics based on their clinical profile and are a better choice because they cause fewer side effects regarding extrapyramidal symptoms (EPS). Even though they provide clear therapeutic benefits, AAP induce peripheral effects that trigger phenotypic, functional, and systemic changes outside the Central Nervous System (CNS). Metabolic disease is frequently associated with AAP and significantly impacts the patient's quality of life. However, other peripheral changes of clinical relevance are present during AAP treatment, such as alterations in the immune and endocrine systems as well as the intestinal microbiome. These less studied alterations also have a significant impact in the patient's health status. This manuscript aims to revise the peripheral immunological, endocrine, and intestinal microbiome changes induced by AAP consumption recommended in the clinical guidelines for schizophrenia and other psychiatric disorders.

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Section: Paliperidonementioning

confidence: 99%

Immunoendocrine Peripheral Effects Induced by Atypical Antipsychotics

et al. 2020

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“…To our understanding, if clozapine alone is to be considered the culprit, this may be explained as an idiosyncratic event, since clozapine titration was performed in both instances over 4 weeks (median of less than 12,5 mg/day increments), and agranulocytosis occurred in week 5, being known that this phenomena is more frequent between weeks 4 and 20 of treatment and is doseindependent [2]. As for paliperidone, it was increased over one week to the same dose of 18 mg in both instances, and there are case reports of agranulocytosis [11] and neutropenia [12,13] with this antipsychotic. The main differences between both trials were the clozapine final dose, which was higher in the second trial (350 mg/day), and the fact that both antipsychotics were started at the same time in the second trial, contrary to the first trial, when paliperidone was initiated firstly and maintained as monotherapy for 18 days.…”

Section: Discussionmentioning

confidence: 99%

Agranulocytosis with combination of paliperidone and clozapine: a case report

Dehanov

Santos

Gonçalves

et al. 2020

CNPT

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“…Previous case reports have shown that paliperidoneinduced neutropenia typically occurs within 14 to 29 days of Hospital Pharmacy 58 (5) exposure while this patient's low counts did not occur until after 46 days of re-initiation and after 98 days of first paliperidone initiation. [2][3][4][5] Ceftriaxone induced agranulocytosis is extremely rare and less common than paliperidone and vancomycin induced leukopenia. In most case reports, it has occurred in a patient on ceftriaxone 2 g IV daily for >21 days.…”

Section: Case Summarymentioning

confidence: 99%

“…9 While this is promising for this patient, he was also on 2 other medications that could have potentiated this event. [2][3][4][5] Vancomycin was determined to be the most likely cause for neutropenia since neutropenia associated with ceftriaxone is less common. Additionally, one change was made at a time since adjusting multiple medications simultaneously would have confounded findings as to the causative agent.…”

Section: Case Summarymentioning

confidence: 99%

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Vancomycin-Induced Leukopenia and Neutropenia: Time Will Tell

Nguyen

Ayyad

2023

Hosp Pharm

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Purpose: Neutropenia is an uncommon adverse effect associated with prolonged vancomycin therapy. Methods: This was a case report on a 62-year-old African American male with hypertension, paranoid schizophrenia, and a history of polysubstance abuse developed foot osteomyelitis. The patient was initially maintained on intravenous Vancomycin & Ceftriaxone for ~3 weeks but adjusted to Daptomycin & Ceftriaxone while in hospital due to neutropenia. Patient’s neutropenia quickly resolved once discontinuation of Vancomycin occurred. Results: Vancomycin is a potential cause of drug induced leukopenia and neutropenia. Monitoring of leukocytes and neutrophils is warranted in patients receiving long term intravenous Vancomycin therapy. Conclusion: Vancomycin is a bactericidal glycopeptide antibiotic with activity against gram-positive organisms such as Staphylococci. Well-known adverse drug events include nephrotoxicity and ototoxicity. Vancomycin-induced neutropenia on the other hand is less common and reported at lower rates. It is defined as an ANC less than 1000 µL in patients maintained on Vancomycin infusions. According to Black et al, neutropenia is more likely associated with prolonged therapy; generally occurring at least 20 days after initiation.

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Acute agranulocytosis when switching from risperidone to paliperidone

Cited by 7 publications

References 3 publications

Immunoendocrine Peripheral Effects Induced by Atypical Antipsychotics

Immunoendocrine Peripheral Effects Induced by Atypical Antipsychotics

Agranulocytosis with combination of paliperidone and clozapine: a case report

Vancomycin-Induced Leukopenia and Neutropenia: Time Will Tell

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