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  • Title: Rapid-onset agranulocytosis in a patient treated with clozapine and lamotrigine.
    Author: Urban AE, Wiglusz MS, Cubała WJ, Landowski J, Krysta K.
    Journal: Psychiatr Danub; 2015 Sep; 27 Suppl 1():S459-61. PubMed ID: 26417816.
    Abstract:
    BACKGROUND: Clozapine is the treatment of choice in drug-resistant schizophrenia. Lamotrigine is a mood stabiliser recommended as combined treatment strategy in clozapine-resistant patients. There are cases of late-onset agranulocytosis reported in literature. Some are associated with clozapine or lamotrigine, others with the combination of both. CASE REPORT: The article presents a case of rapid-onset agranulocytosis in a 60-year old clozapine-resistant patient, in whom lamotrigine was introduced as potentiation strategy. Discontinuation of both substances and GCSF treatment resulted in normalization of the absolute neutrophil count. CONCLUSIONS: The case suggests a possibility of developing rapid-onset agranulocytosis in clozapine-resistant patients who require lamotrigine as augmentation strategy. This emphasises the significance of monitoring a patient's blood count and early management of any dyscrasias noticed.
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