Etain B, Roubaud L, Le Heuzey M F, Mouren Simeoni M C
Service de Psychopathologie de l'Enfant et de l'Adolescent, Hôpital Robert Debré, 48, boulevard Sérurier, 75019 Paris.
Encephale. 2000 Sep-Oct;26(5):81-4.
The safety and efficacity of atypical antipsychotics in comparison with conventional neuroleptics allow their prescription in children and adolescents who are particularly at risk for developing neurological or cardiac side-effects. Hematological complications of new antipsychotics are less known, except for clozapine treatment in which blood monitoring strategy is well established. We report on a case of risperidone-associated leucopenia in an african adolescent treated for schizophrenia. He developed leucopenia 10 days after starting risperidone therapy (4 mg/day). The cessation of treatment was followed by a normalization of the white blood cell differential count and the rechallenge was positive (2 mg/day). No hematological abnormalities were observed with olanzapine therapy in this patient. Therefore olanzapine may represent a safe therapeutic alternative. We concluded that risperidone therapy may create a risk for leucopenia especially in patients who present a risk of leucopenia for ethnic reasons. We propose hematological monitoring during risperidone treatment.
与传统抗精神病药物相比，非典型抗精神病药物的安全性和有效性使得它们可以用于那些特别容易出现神经或心脏副作用的儿童和青少年。新型抗精神病药物的血液学并发症鲜为人知，除了氯氮平治疗，其血液监测策略已很成熟。我们报告一例在接受精神分裂症治疗的非洲青少年中与利培酮相关的白细胞减少症病例。他在开始利培酮治疗（4毫克/天）10天后出现白细胞减少症。停药后白细胞分类计数恢复正常，再次用药试验呈阳性（2毫克/天）。该患者接受奥氮平治疗时未观察到血液学异常。因此，奥氮平可能是一种安全的治疗选择。我们得出结论，利培酮治疗可能会导致白细胞减少症的风险，尤其是对于因种族原因存在白细胞减少症风险的患者。我们建议在利培酮治疗期间进行血液学监测。
