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  • Title: Add-on filgrastim during clozapine rechallenge unsuccessful in preventing agranulocytosis.
    Author: Hazewinkel AW, Bogers JP, Giltay EJ.
    Journal: Gen Hosp Psychiatry; 2013; 35(5):576.e11-2. PubMed ID: 23395419.
    Abstract:
    Granulocyte colony-stimulating factor agents such as filgrastim can be administered in order to reduce the duration of clozapine-induced agranulocytosis. Successful long-term combination treatment with filgrastim and clozapine in patients with previous clozapine-induced agranulocytosis has been described in several cases. We describe a patient with schizophrenia who developed agranulocytosis during treatment with clozapine and who did not respond to other antipsychotics. Add-on treatment with filgrastim during a clozapine rechallenge did not prevent the reoccurrence of agranulocytosis, and clozapine treatment had to be discontinued. Our case suggests that add-on filgrastim is a therapeutic option when clozapine is rechallenged, but physicians should be aware of the potential dangers especially severe clozapine-induced agranulocytosis.
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