title: Quetiapine XR-induced neutropenia: is a clozapine trial still possible for treatment-resistant schizophrenia? A case report.
abstract: OBJECTIVE
  Our case report addresses the use of clozapine in patients who have a history of quetiapine XR-induced neutropenia. There are no current guidelines for this situation.
  
  
  METHODS
  We present the case of a young woman treated with clozapine at a first-episode psychosis clinic after a moderate quetiapine XR-induced neutropenia (0,5-1,0 × 10(9)  L(-1) ).
  
  
  RESULTS
  The patient was successfully treated with clozapine and lithium, with less psychotic symptoms and a better level of functioning. The neutrophil count remained normal during the treatment period, which has been longer than a year.
  
  
  CONCLUSIONS
  The outcome of this case supports the notion that clinicians could consider introducing clozapine in treatment-refractory patients who have a history of quetiapine XR-induced neutropenia, with close blood monitoring. Lithium co-administration may play a role in maintaining a normal neutrophil count.
authors.affiliation: Department of Psychiatry and Neurosciences, Laval University, Québec, Québec, Canada.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Crépeau-Gendron
authors.forename: Sophie
authors.initials: S
authors.lastname: L'Heureux
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D003024:Clozapine / Q000627:therapeutic use*; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000009:adverse effects; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D009503:Neutropenia / Q000139:chemically induced*; D009504:Neutrophils; D000069348:Quetiapine Fumarate / Q000008:administration & dosage / Q000009:adverse effects*; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D000069348:Quetiapine Fumarate; D003024:Clozapine
keywords: agranulocytosis; antipsychotic agent; clozapine; neutropenia; quetiapine