Treatment of clozapine- and molindone-induced agranulocytosis with granulocyte colony-stimulating factor.
OBJECTIVE
To report a case of clozapine- and molindone-induced agranulocytosis and to discuss treatment using filgrastim, a granulocyte colony-stimulating factor.


METHODS
A 64-year-old woman who had been on long-term clozapine therapy for schizophrenia was hospitalized with presumed drug-induced agranulocytosis. She had also been on short-term molindone therapy. A bone marrow biopsy and the initial white blood cell (WBC) count were consistent with drug-induced agranulocytosis. Following seven days of treatment with subcutaneous filgrastim 300 micrograms/d, her absolute neutrophil count was above 500 x 10(6)/L.


CONCLUSIONS
Reports in the literature discussing antipsychotic drug-induced agranulocytosis are reviewed. A relationship between treatment with filgrastim and WBC response is postulated.


CONCLUSIONS
Filgrastim may be useful in ameliorating the effects of clozapine- and molindone-induced agranulocytosis.
Geibig
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CB
Department of Pharmaceutical Services, Saint Mary's Health Services, Grand Rapids, MI 49503.
Marks
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D000380:Agranulocytosis / Q000139:chemically induced* / Q000188:drug therapy*; D003024:Clozapine / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007279:Injections, Subcutaneous; D008875:Middle Aged; D008972:Molindone / Q000009:adverse effects*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D003024:Clozapine; D000069585:Filgrastim; D008972:Molindone