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  • Title: Neutropenia and agranulocytosis in patients receiving clozapine in the UK and Ireland.
    Author: Atkin K, Kendall F, Gould D, Freeman H, Liberman J, O'Sullivan D.
    Journal: Br J Psychiatry; 1996 Oct; 169(4):483-8. PubMed ID: 8894200.
    Abstract:
    BACKGROUND: Clozapine can cause reversible agranulocytosis and neutropenia. This study documents the occurrence of blood dyscrasias and identifies predisposing risk factors. METHOD: An analysis was made of the haematological, demographic, and dosage data from a central database on 6316 patients receiving clozapine over four and a half years in the UK and Ireland. RESULTS: During the study period, 2.9% of the patients developed neutropenia and 0.8% developed agranulocytosis. The peak incidence of both disorders was in the first 6-18 weeks of treatment. Fatal agranulocytosis occurred in 0.03% of patients. After the first year of treatment, the incidence of agranulocytosis significantly decreased to the order noted with some phenothiazines. CONCLUSIONS: The use of a patient monitoring service kept the haematological risks associated with using clozapine within acceptable limits, particularly in view of the benefits of this medication in treatment-resistant schizophrenia.
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