Hummer M, Kurz M, Barnas C, Fleischhacker W W
Department of Psychiatry, Innsbruck University Clinics, Austria.
Psychopharmacol Bull. 1992;28(3):287-90.
Blood dyscrasias are frequently reported to be induced by the atypical antipsychotic clozapine. Next to agranulocytosis, a potentially lethal form of these side effects, hematologic disturbances include leucocytosis, eosinophilia, and neutropenia. Neutropenia is of considerable clinical relevance because it can be a sign of incipient agranulocytosis. In an analysis of our clozapine drug monitoring program, we have analyzed the data from 68 patients receiving clozapine for the first time. Neutrophil granulocytes dropped to 290 and 660/mm3 in 2 patients, both recovered after the discontinuation of clozapine. Another patient with a granulocyte count of 1800/mm3 was stopped because regular white blood cell monitoring was not possible. Eight additional patients demonstrated a transient decrease of granulocytes during ongoing clozapine administration. This amounts to a cumulative incidence of transient neutropenia of 22 percent (95% confidence interval 7.5%-36.5%).
血液系统异常常被报道为由非典型抗精神病药物氯氮平诱发。除了粒细胞缺乏症（这些副作用的一种潜在致命形式）之外，血液学紊乱还包括白细胞增多、嗜酸性粒细胞增多和中性粒细胞减少。中性粒细胞减少具有相当大的临床相关性，因为它可能是早期粒细胞缺乏症的迹象。在对我们的氯氮平药物监测项目的分析中，我们分析了68例首次接受氯氮平治疗的患者的数据。2例患者的中性粒细胞降至290和660/mm³，在停用氯氮平后均恢复。另一名粒细胞计数为1800/mm³的患者因无法进行常规白细胞监测而停药。另外8例患者在持续服用氯氮平期间出现粒细胞短暂减少。这相当于短暂性中性粒细胞减少的累积发生率为22%（95%置信区间7.5%-36.5%）。
