Late-Onset Neutropenia in Long-Term Clozapine Use and Its Management Utilizing Prophylactic G-CSF
This case outlines recurrent neutropenia after fourteen years of successful clozapine use. The patient has a diagnosis of treatment-resistant schizophrenia which has been complicated by sensitivity to side effects of haloperidol and past failure of antipsychotics to manage her symptoms. It was neces...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
|
| Series: | Case Reports in Psychiatry |
| Online Access: | http://dx.doi.org/10.1155/2021/6640681 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850208938207739904 |
|---|---|
| author | Eimear O’ Neill Deirdre Carolan Sarah Kennedy Sandra Barry |
| author_facet | Eimear O’ Neill Deirdre Carolan Sarah Kennedy Sandra Barry |
| author_sort | Eimear O’ Neill |
| collection | DOAJ |
| description | This case outlines recurrent neutropenia after fourteen years of successful clozapine use. The patient has a diagnosis of treatment-resistant schizophrenia which has been complicated by sensitivity to side effects of haloperidol and past failure of antipsychotics to manage her symptoms. It was necessary for our patient to follow a complicated treatment path involving close monitoring of blood levels, admissions, the initiation of lithium and the regular use of filgrastim (Neupogen), granulocyte colony stimulating factor (G-CSF). Following a failure of rescue filgrastim to increase her neutrophil levels, a management protocol was designed with input from the on-site hematology team. This protocol involved the use of filgrastim on a regular prophylactic basis. This management plan has worked for the patient who has been able to continue use of clozapine and has not suffered from any neutropenic episodes in over six months. |
| format | Article |
| id | doaj-art-9805549be13044dcaecb5b3a5e430be3 |
| institution | OA Journals |
| issn | 2090-682X 2090-6838 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Psychiatry |
| spelling | doaj-art-9805549be13044dcaecb5b3a5e430be32025-08-20T02:10:08ZengWileyCase Reports in Psychiatry2090-682X2090-68382021-01-01202110.1155/2021/66406816640681Late-Onset Neutropenia in Long-Term Clozapine Use and Its Management Utilizing Prophylactic G-CSFEimear O’ Neill0Deirdre Carolan1Sarah Kennedy2Sandra Barry3St. Stephen’s Psychiatric Hospital, Sarsfield Court, Glanmire, Cork, IrelandMercy University Hospital, Glenville place, Cork, IrelandCUMH, Cork University Hospital, Wilton, Cork, IrelandMercy University Hospital, Glenville place, Cork, IrelandThis case outlines recurrent neutropenia after fourteen years of successful clozapine use. The patient has a diagnosis of treatment-resistant schizophrenia which has been complicated by sensitivity to side effects of haloperidol and past failure of antipsychotics to manage her symptoms. It was necessary for our patient to follow a complicated treatment path involving close monitoring of blood levels, admissions, the initiation of lithium and the regular use of filgrastim (Neupogen), granulocyte colony stimulating factor (G-CSF). Following a failure of rescue filgrastim to increase her neutrophil levels, a management protocol was designed with input from the on-site hematology team. This protocol involved the use of filgrastim on a regular prophylactic basis. This management plan has worked for the patient who has been able to continue use of clozapine and has not suffered from any neutropenic episodes in over six months.http://dx.doi.org/10.1155/2021/6640681 |
| spellingShingle | Eimear O’ Neill Deirdre Carolan Sarah Kennedy Sandra Barry Late-Onset Neutropenia in Long-Term Clozapine Use and Its Management Utilizing Prophylactic G-CSF Case Reports in Psychiatry |
| title | Late-Onset Neutropenia in Long-Term Clozapine Use and Its Management Utilizing Prophylactic G-CSF |
| title_full | Late-Onset Neutropenia in Long-Term Clozapine Use and Its Management Utilizing Prophylactic G-CSF |
| title_fullStr | Late-Onset Neutropenia in Long-Term Clozapine Use and Its Management Utilizing Prophylactic G-CSF |
| title_full_unstemmed | Late-Onset Neutropenia in Long-Term Clozapine Use and Its Management Utilizing Prophylactic G-CSF |
| title_short | Late-Onset Neutropenia in Long-Term Clozapine Use and Its Management Utilizing Prophylactic G-CSF |
| title_sort | late onset neutropenia in long term clozapine use and its management utilizing prophylactic g csf |
| url | http://dx.doi.org/10.1155/2021/6640681 |
| work_keys_str_mv | AT eimearoneill lateonsetneutropeniainlongtermclozapineuseanditsmanagementutilizingprophylacticgcsf AT deirdrecarolan lateonsetneutropeniainlongtermclozapineuseanditsmanagementutilizingprophylacticgcsf AT sarahkennedy lateonsetneutropeniainlongtermclozapineuseanditsmanagementutilizingprophylacticgcsf AT sandrabarry lateonsetneutropeniainlongtermclozapineuseanditsmanagementutilizingprophylacticgcsf |