The Incidence of Clozapine-induced Leukopenia in schizophrenic patients at Roiet Hospital

Abstract

Clozapine an atypical antipsychotic drug,is only 30-60 % effective in patients who resist to treatment with other antipsychotic drugs.The most important adverse effect of this drug is agranulocytosis and death from infection.There is still lack of evidence to show the incidence of clozapine-induced agranulocytosis and other related hematological side effects at Roiet Hospital.Realizing how fatal agranulocytosis is,early detection is necessary.Therefore,the incidence of clozapine-induced leukopenia,neutropenia,and agranulocytosis in patients with schizophrenia and factors associated with leukopenia should be studied.In this study was done by retrospective reviews of the medical records of schizophrenic inpatients at psychiatric ward in Roiet Hospital who had received clozapine from June       1^st ,2008  to May 31^st,2009.The demographic data,factors association,the data of concentration of white blood cells,neutrophil,incidence rate,and incidence density of leukopenia,  neutropenia,and agranulocytosis were collected.There were  58 patients met the inclusion criteria.One patients developed leukopenia and neutropenia.The incidence rate of leukopenia and neutropenia was 1.72 and the incidence density of leukopenia and neutropenia was 0.04/year.No agranulocytosis was found in the present study.The complete blood counts were not obtained regulary due to the problems of patient’s adherence and variations in practice among the physicians. Sex,age, occupations, marital status,education,use of clozapine alone,use of clozapine with another drugs did not associated with leukopenia,neutropenia.Although this study indicated that the incidence of leucopenia and neutropenia were not striking,and agranulocytosis was  not found,further study should be made to gather more data to determine the association between risk factors and leucopenia,neutropenia and agranulocytosis.Such investigation has to be done completely and accordingly to the safety blood monitoring of this drug usage in order to reduce the agranulocytosis in these psychotic patients.