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Adjunctive use of lithium carbonate for the management of neutropenia in clozapine‐treated children
Author(s) -
Mattai Anand,
Fung Lawrence,
Bakalar Jennifer,
Overman Gerald,
Tossell Julia,
Miller Rachel,
Rapoport Judith,
Gogtay Nitin
Publication year - 2009
Publication title -
human psychopharmacology: clinical and experimental
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.461
H-Index - 78
eISSN - 1099-1077
pISSN - 0885-6222
DOI - 10.1002/hup.1056
Subject(s) - clozapine , discontinuation , lithium carbonate , neutropenia , antipsychotic , medicine , lithium (medication) , schizophrenia (object oriented programming) , pediatrics , psychiatry , chemotherapy , chemistry , ion , organic chemistry , ionic bonding
Objective Clozapine, a dibenzodiazepine antipsychotic, is the most effective medication for treatment‐resistant schizophrenia. However, its use has been limited by the high risk of neutropenia. In children, the rate of neutropenia is higher when compared to adults. We decided to explore the use of lithium to manage neutropenia in childhood‐onset schizophrenia (COS) through a systematic audit of COS cases. Methods Medical records were reviewed for patients with COS who had been treated with the combination of clozapine and lithium carbonate. Results Seven patients were found to have been treated with both clozapine and lithium. After initiation of lithium, ANC increased significantly in six out of seven subjects by 29 to 106% with a mean of 66%. In addition, six out of seven subjects continued using both clozapine and lithium for over 2 years (range: 2.0–7.2 years) and do not have immediate plans for discontinuation of either medications. Conclusions Our study bolsters support for the use of lithium in the management of neutropenia in children treated with clozapine. Although the coadministration of lithium and clozapine appears effective in the management of neutropenia, it is not without its risks and clinicians must be diligent in their joint use of these medications. Published in 2009 by John Wiley & Sons, Ltd.