title: Severe granulocytopenia secondary to chlorpromazine despite concurrent lithium treatment: a case report.
abstract: Severe chlorpromazine-induced granulocytopenia where the white-cell count decreases to below 1,000/mm3 rarely occurs and lithium is known to cause leucocytosis. The use of lithium in the prevention of granulocytopenia induced by drugs is still controversial. This report describes a patient with bipolar disorder suffering from severe granulocytopenia and severe respiratory infection after receiving chlorpromazine 50 to 150 mg per day along with long term lithium therapy. Bone-marrow aspiration and biopsy revealed inhibited maturation of myeloid series in the promyelocyte stage. The findings were consistent with a drug-induced effect. White-cell count return to normal after the discontinuation of chlorpromazine. It was proved in this case that combined lithium therapy had no effect in preventing agranulocytosis induced by chlorpromazine.
authors.affiliation: Department of Psychiatry, Kaohsiung Medical College, Taiwan, Republic of China.
authors.forename: C F
authors.initials: CF
authors.lastname: Yen
authors.forename: M Y
authors.initials: MY
authors.lastname: Chong
authors.forename: M C
authors.initials: MC
authors.lastname: Kuo
authors.forename: C S
authors.initials: CS
authors.lastname: Chang
mesh_terms: D000368:Aged; D000380:Agranulocytosis / Q000139:chemically induced* / Q000517:prevention & control; D014150:Antipsychotic Agents / Q000009:adverse effects*; D002746:Chlorpromazine / Q000009:adverse effects*; D006801:Humans; D008094:Lithium / Q000627:therapeutic use*; D008297:Male
chemical_list: D014150:Antipsychotic Agents; D008094:Lithium; D002746:Chlorpromazine