Haloperidol-related neutropenia

Abstract

Phenothiazines like antipsychotics have been known to cause neutropenia, but this has been reported very rarely with haloperidol. A 20-year-old male patient admitted to emergency service (emergency room) with shortness of breath, chest pain, and anger. He was diagnosed with pneumonia and prescribed moxifloxacin. After 2 days with antibiotic, he readmitted. Left lung pneumothorax was detected, and thorax computerized tomography was requested. However, he opposed and beated one of the hospital officials. The diagnosis of manic episode due to antibiotic moxifloxacin was considered. The tube thoracostomy had to be done, and antibiotic therapy was stopped. Haloperidol 10 mg/day and biperiden 4 mg/day injections were administered because he continued to resist medical interventions. After haloperidol, his leukocyte count decreased. He responded well to filgrastim (Neupogen) and blood transfusions, so a drug-related cause of neutropenia has been suspected. He was switched from haloperidol to quetiapine 300 mg twice a day. His white blood cell count returned to normal levels.

Probable haloperidol decanoate-induced fever in an African American with benign ethnic neutropenia: A case report

“…Sahan 12 describes a case of a patient with haloperidol lactate-related neutropenia, which resolved with filgrastim and changing to quetiapine. In comparison, the patient reported here showed leukocytosis and slight neutrophilia with administration of the decanoate formulation.…”

Sex-dependent effects of long-term clozapine or haloperidol medication on red blood cells and liver iron metabolism in Sprague Dawley rats as a model of metabolic syndrome

“…Medical comorbidities like diabetes mellitus enhance the risk to develop anemia under clozapine medication, whereas smoking seems to lower the risk of anemia only in men by upregulating the hemoglobin level in men. In contrast to clozapine, haloperidol rarely causes hematologic side effects like leukopenia [ 8 ] or neutropenia [ 9 , 10 ].…”