Leucopenia induced by low dose clozapine in Parkinson's disease recedes shortly after drug withdrawal. Clinical case descriptions with commentary on switch-over to olanzapine.
Four patients affected by severe Parkinson's disease developed leucopenia (900-1200 WBC) during treatment of psychosis (3) or untreatable insomnia (1) with clozapine (37.5-75 mg/day). Clozapine withdrawal was followed by recovery of leucopenia (4000-6000 WBC) in two weeks with no need for the administration of leucokines. After 1-6 months olanzapine was administered (increasing the dose from 2.5 to 10 mg/day) to treat persisting disturbances, but the drug induced severe worsening of parkinsonism and also this drug had to be withdrawn.
Onofrj
M
M
Department of Oncology and Neuroscience, University G. D'Annunzio, Pescara, Italy.
Thomas
A
A
Bonanni
L
L
Iacono
D
D
Gambi
F
F
D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001569:Benzodiazepines; D003024:Clozapine / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006212:Hallucinations / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced* / Q000503:physiopathology; D008297:Male; D000077152:Olanzapine; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D010890:Pirenzepine / Q000008:administration & dosage / Q000009:adverse effects* / Q000031:analogs & derivatives*; D011618:Psychotic Disorders / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D020018:Sexual Dysfunctions, Psychological / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D010890:Pirenzepine; D003024:Clozapine; D000077152:Olanzapine