Campion Paul, Campion Gabriel, Anbarasan Deepti
From the *Department of Psychiatry, Bronx VA Medical Center, Bronx; †New York University School of Medicine; and ‡Department of Neurology, New York-Presbyterian/Columbia University School of Medicine, New York, NY.
J Clin Psychopharmacol. 2017 Aug;37(4):456-458. doi: 10.1097/JCP.0000000000000733.
There is a paucity of literature regarding the effect of antipsychotics on absolute neutrophil count (ANC) of patients with benign neutropenia (BN). We evaluated the change in ANC after atypical antipsychotic prescription (excluding clozapine) in a retrospective cohort of 22 patients with BN.
METHODS/PROCEDURES: Records of all patients with BN who were prescribed antipsychotics and who had ANC measured before and during antipsychotic treatment were obtained from Bronx VA Medical Center between 2005 and 2015 (inclusive). Twenty-two patients met criteria for inclusion. Individual and group mean ANC were calculated before treatment and during treatment. A paired, two-tailed t test was performed on the group ANC means.
The group mean pretreatment ANC was 1.24 ± 0.220 K/cmm, and the mean ANC during the time of antipsychotic prescription increased to 1.40 ± 0.230 K/cmm, with a P value of 0.0045, t value of 3.18, degrees of freedom equal to 21, and 95% confidence interval of 1.30 to 1.49 K/cmm.
There was a statistically significant increase in ANC among our cohort during the time of antipsychotic prescription. All BN patients who were prescribed antipsychotics maintained a stable neutrophil count, with none of the 22 patients with BN in this study developing agranulocytosis during treatment. Although this study is limited by a low patient count as well as other demographic factors, these findings provide initial evidence regarding the safety of prescribing atypical antipsychotics to BN patients. Further studies are needed to replicate these findings and assess for effects of individual medications.
关于抗精神病药物对良性中性粒细胞减少症（BN）患者的绝对中性粒细胞计数（ANC）的影响，相关文献较少。我们在一个22例BN患者的回顾性队列中评估了非典型抗精神病药物（不包括氯氮平）处方后的ANC变化。
方法/步骤：从2005年至2015年（含）期间的布朗克斯退伍军人医疗中心获取了所有开具抗精神病药物且在抗精神病治疗前和治疗期间进行了ANC测量的BN患者的记录。22例患者符合纳入标准。计算治疗前和治疗期间的个体及组平均ANC。对组ANC均值进行配对双尾t检验。
组平均治疗前ANC为1.24±0.220K/cmm，抗精神病药物处方期间的平均ANC增加到1.40±0.230K/cmm，P值为0.0045，t值为3.18，自由度等于21，95%置信区间为1.30至1.49K/cmm。
在抗精神病药物处方期间，我们队列中的ANC有统计学显著增加。所有开具抗精神病药物的BN患者中性粒细胞计数保持稳定，本研究中的22例BN患者在治疗期间均未发生粒细胞缺乏症。尽管本研究受患者数量少以及其他人口统计学因素限制，但这些发现为给BN患者开具非典型抗精神病药物的安全性提供了初步证据。需要进一步研究来重复这些发现并评估个体药物的效果。
