Continuing clozapine despite neutropenia.
BACKGROUND
A 40-year-old chronic schizophrenic patient whose psychosis and associated violent behaviour resolved on clozapine, required chemotherapy for a testicular teratoma with pulmonary metastases. His treatment was initially delayed due to refusal to consent.


METHODS
The patient finally agreed to orchidectomy and cytotoxic therapy, and following agreement by the CPMS, clozapine continued to be dispensed despite neutropenia and 'red alert' status on full blood count.


CONCLUSIONS
This is the only patient to continue clozapine despite 'red alert' status, and as such is an exceptional case, but may open the way for such patients in the future.
Wesson
M L
ML
Department of Medical Oncology, Clatterbridge Hospital, Merseyside.
Finnegan
D M
DM
Clark
P I
PI
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D017024:Chemotherapy, Adjuvant; D003024:Clozapine / Q000008:administration & dosage / Q000009:adverse effects*; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006801:Humans; D008297:Male; D009503:Neutropenia / Q000139:chemically induced*; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D012565:Schizophrenic Psychology; D013724:Teratoma / Q000150:complications / Q000188:drug therapy; D013736:Testicular Neoplasms / Q000150:complications / Q000188:drug therapy; D016312:Treatment Refusal / Q000523:psychology; D014754:Violence / Q000517:prevention & control / Q000523:psychology
D014150:Antipsychotic Agents; D003024:Clozapine