Risperidone-Induced Neutropenia in a Schizophrenic Patient: A Case Report and Literature Review

Abstract

Neutropenia is an adverse effect of various pharmacological therapies, including antipsychotics. Among the second-generation antipsychotic (SGA) medications, clozapine is most notable for neutropenic adverse effect. Risperidone, another SGA drug, is linked mainly with metabolic adverse effects, but rarely, blood dyscrasia adverse reactions have been reported. Hence, we report the case of a 56-year-old African American woman who developed severe neutropenia following two weeks of oral risperidone treatment. Her neutrophil levels returned to normal limits following discontinuation of risperidone and switching to haloperidol.

Risperidone-Induced Leukoneutropenia: Evidence from a Positive Rechallenge and Review of the Literature

“…More recently, Atolagbe et al reported the case of a 56-year-old African American female who experienced a significant drop in her neutrophil count after taking oral risperidone for two weeks. Her neutrophil levels returned to the normal range when she stopped taking risperidone and switched to haloperidol [21].…”

“…A literature search was done on PubMed database (MeSH terms: risperidone, leukopenia and/or neutropenia ) for available evidence on management of risperidone-induced leukopenia and/or neutropenia either with rechallenging or not includes 18 case reports of risperidone-induced leukoneutropenia as shown in the ▶Table 1 [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. The mean age was 44.06 (range: 7 to 90 years old).…”

“…Leukoneutropenia rarely develops while using an antipsychotic treatment. Most often caused by clozapine or olanzapine, the issue is typically resolved by switching to another antipsychotic [22], like haloperidol [9,12,21]. However, there are anecdotal reports of leukopenia or neutropenia associated with risperidone, there is currently no evidence-based guidance available to suggest alternative antipsychotic medications [21].…”