title: Rapid-onset agranulocytosis in a patient treated with clozapine and lamotrigine.
abstract: BACKGROUND
  Clozapine is the treatment of choice in drug-resistant schizophrenia. Lamotrigine is a mood stabiliser recommended as combined treatment strategy in clozapine-resistant patients. There are cases of late-onset agranulocytosis reported in literature. Some are associated with clozapine or lamotrigine, others with the combination of both.
  
  
  METHODS
  The article presents a case of rapid-onset agranulocytosis in a 60-year old clozapine-resistant patient, in whom lamotrigine was introduced as potentiation strategy. Discontinuation of both substances and GCSF treatment resulted in normalization of the absolute neutrophil count.
  
  
  CONCLUSIONS
  The case suggests a possibility of developing rapid-onset agranulocytosis in clozapine-resistant patients who require lamotrigine as augmentation strategy. This emphasises the significance of monitoring a patient's blood count and early management of any dyscrasias noticed.
authors.affiliation: Department of Psychiatry, Medical University of Gdańsk, Dębinki 7 St. build. 25, 80-952 Gdańsk, Poland.
authors.forename: Anna Emilia
authors.initials: AE
authors.lastname: Urban
authors.forename: Mariusz S
authors.initials: MS
authors.lastname: Wiglusz
authors.forename: Wiesław Jerzy
authors.initials: WJ
authors.lastname: Cubała
authors.forename: Jerzy
authors.initials: J
authors.lastname: Landowski
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Krysta
mesh_terms: D000380:Agranulocytosis / Q000139:chemically induced*; D003024:Clozapine / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D007958:Leukocyte Count; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects; D012563:Schizophrenia, Paranoid / Q000188:drug therapy; D013997:Time Factors; D014227:Triazines / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D014227:Triazines; D003024:Clozapine; D000077213:Lamotrigine