title: Incidence of Neutropenia With Valproate and Quetiapine Combination Treatment in Subjects With Acquired Brain Injuries.
abstract: OBJECTIVE
  To investigate whether the incidence of neutropenia was higher in subjects who received a combination treatment with valproate and quetiapine than in those who were administered monotherapy.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Rehabilitation department of a university hospital.
  
  
  METHODS
  Patients with acquired brain injuries who had taken valproate for seizures or quetiapine for delirium for >7 days (N=101). Data were extracted from electronic medical records of the hospital.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Incidence of neutropenia (absolute neutrophil count<2000 cells/μL) was elicited from the weekly complete blood cell records for 71.07±43.71 days of observation. The odds ratio for neutropenia development was calculated and adjusted for variables that showed significant differences between patients with or without neutropenia.
  
  
  RESULTS
  The incidence of neutropenia was significantly higher in the group receiving the combination treatment than in those receiving the monotherapy (32.26% vs 12.90%, adjusted P=.036), despite a lack of any differences in the daily doses of the medications. Coadministration of quetiapine and valproate was the predictor of neutropenia development when age, body weight, and underlying diseases were adjusted in the logistic regression model (odds ratio=3.749; 95% confidence interval, 1.161-12.099; P=.027).
  
  
  CONCLUSIONS
  Administration of quetiapine together with valproate in patients with acquired brain injury could increase the incidence of medication-induced neutropenia.
authors.affiliation: Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, South Korea.
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Ewha Brain Institute, Ewha Womans University, Seoul, South Korea. Electronic address: jungyoon.kimm@gmail.com.
authors.forename: Jung Yoon
authors.initials: JY
authors.lastname: Kim
mesh_terms: D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects*; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001930:Brain Injuries / Q000150:complications*; D015331:Cohort Studies; D003693:Delirium / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced*; D000069348:Quetiapine Fumarate / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D014635:Valproic Acid / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000927:Anticonvulsants; D014150:Antipsychotic Agents; D000069348:Quetiapine Fumarate; D014635:Valproic Acid
keywords: Brain injuries; Dibenzothiazepines; Neutropenia; Rehabilitation; Valproic acid