Sedky Karim, Lippmann Steven
Drexel University College of Medicine, Philadelphia, PA, USA.
Curr Drug Targets. 2006 Sep;7(9):1191-4. doi: 10.2174/138945006778226642.
Neutropenia and/or agranulocytosis are among the medicinal side-effects induced by many psychotropic drugs. Clozapine and carbamazepine cause the highest incidence of this side-effect and require long-term blood cell monitoring. Bone marrow suppression can have an allergic, hypersensitivity etiology (e.g., clozapine), which mandates the causative drug discontinuation. It can also be a direct, toxic effect (e.g., carbamazepine), which calls for dosage reduction or a medication change. Other treatment options may include filgrastim, sargramostim, or lithium. Blood cell count monitoring is encouraged on patients receiving clozapine as long as the drug is continued. Such evaluation is also advised on those medicated with other psychotropics, especially carbamazepine.
中性粒细胞减少和/或粒细胞缺乏症是许多精神药物引起的药物副作用之一。氯氮平和卡马西平导致这种副作用的发生率最高,需要长期进行血细胞监测。骨髓抑制可能有过敏、超敏反应病因(如氯氮平),这就要求停用致病药物。它也可能是直接的毒性作用(如卡马西平),这就需要减少剂量或更换药物。其他治疗选择可能包括非格司亭、沙格司亭或锂盐。只要继续使用氯氮平,就鼓励对接受该药治疗的患者进行血细胞计数监测。对于使用其他精神药物,尤其是卡马西平治疗的患者,也建议进行此类评估。