Clozapine-induced neutropenia, or not

Atkin, K; Veys, Paul

doi:10.1192/bjp.165.3.407b

Cited by 4 publications

(3 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, agranulocytosis is not a dose dependent side-effect (Alvir et al, 1993). In the UK the annual risks of neutropenia and agranulocytosis are 3.8% and 0.76 % respectively (Atkin, 1994). The risk of fatal agranulocytosis is 0.030/0 (1 in 3158 patients).…”

Section: Who Should Receive Clozapine?mentioning

confidence: 99%

See 1 more Smart Citation

Management of Treatment Refractory Schizophrenia

Morrison

1996

Br J Psychiatry

View full text Add to dashboard Cite

There is a general consensus that 5–25% of schizophrenic patients are partially or totally unresponsive to antipsychotic drug therapy (Brenner et al, 1990). Agreement is needed on how to define the varying degrees of response and resistance in individual patients on conventional antipsychotic medication. Apparent “treatment resistance” may be due to noncompliance; excessive protein binding with inadequate bio-availability of the neuroleptic; an inadequate or excessive dose resulting in poor efficacy or side-effects outweighing therapeutic effects (Osser, 1989); or incorrect diagnosis.

show abstract

Section: Who Should Receive Clozapine?mentioning

confidence: 99%

“…The risk of fatal agranulocytosis is 0.030/0 (1 in 3158 patients). The risk of agranulocytosis falls markedly after the first year of treatment (Atkin, 1994).…”

Section: Who Should Receive Clozapine?mentioning

confidence: 99%

Management of Treatment Refractory Schizophrenia

Morrison

1996

Br J Psychiatry

View full text Add to dashboard Cite

show abstract

“…The risks of adverse haematological effects associated with antipsychotic drugs have been well publicized and have led to stringent monitoring requirements in the case of clozapine and withdrawal from the market in the case of remoxipride (Committee on Safety of Medicines, 1993;Kerwin, 1993;Atkin and Veys, 1994). However, although the existence of such risks is well-established, it remains difficult to estimate their true prevalence and, in particular, to reach well-founded conclusions about the relative safety of different compounds.…”

Section: Introductionmentioning

confidence: 97%

Haematological safety of antipsychotic drugs

King

Wager

1998

J Psychopharmacol

View full text Add to dashboard Cite

Many clinicians have become concerned about the safety of new antipsychotics particularly in view of the association of agranulocytosis with clozapine and of aplastic anaemia with remoxipride. The Committee on Safety of Medicines and Medicines Control Agency 'yellow card' post-marketing surveillance data were analysed for reports of haemopoietic disorders with the 16 antipsychotics in common use. Corrections for relative risk were made in three separate ways: (i) control for degree of use, using Northern Ireland prescribing data for 1995; (ii) percentage of total reports from 1963 to 1996; and (iii) examination of the first 5 years' post-marketing data only. After clozapine and remoxipride the highest risks of haemopoietic reactions appeared to be associated with the aliphatic phenothiazine derivatives thioridazine and chlorpromazine. There is therefore no evidence of any increased risk with high-potency drugs such as haloperidol or pimozide or with the newer drugs such as sulpiride or risperidone. Continued vigilance, however, is necessary as more new atypicals become available and begin to be widely prescribed.

show abstract