title: [Hematological Evaluation and Monitoring in Adult Patients Diagnosed With Schizophrenia].
abstract: OBJECTIVE
  To guide the clinician in taking decisions on the best strategies for assessing and monitoring the risk of blood disorders in adults diagnosed with schizophrenia in pharmacological treatment.
  
  
  METHODS
  A clinical practice guideline was developed following the guidelines of the Methodological Guide of the Ministry of Social Protection to collect evidence and grade recommendations. De novoliterature researchwas performed.
  
  
  RESULTS
  With the use of antipsychotics there isriskofreducción in the leukocyte count and the risk of agranulocytosis,the later associated with the use of clozapine, although it is a rare event(0.8%) can be fatal; this effect occurs most frequently in the first twelve weeks of treatment and the risk is maintained aroundthe first year of it.
  
  
  CONCLUSIONS
  The recommendations were considered strongin all hematologic related monitoring.A blood count should be taken at the start of pharmacological treatment. If the patient is started on clozapine one shouldbe taken weekly during the first three months, monthly until completing one year and every six months thereafter. If there is a decrease in white blood cell count the patient should be monitored regularly, stopping if is a less than 3,500 cells/mm(3) and consider referral if is less than 2,000 cells/mm(3).
authors.affiliation: Médica psiquiatra, candidata a magístra Epidemiología Clínica. Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Tamayo Martínez
authors.affiliation: Médica psiquiatra, magístra en Epidemiología Clínica. Profesora asistente del departamento de Psiquiatría y Salud Mental. Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: Adriana Patricia
authors.initials: AP
authors.lastname: Bohórquez Peñaranda
authors.affiliation: Médica psiquiatra, Doctora en Epidemiología Clínica. Profesora titular del Departamento de Psiquiatría, Facultad de Medicina. Universidad de Antioquia., Medellín, Antioquia, Colombia.
authors.forename: Jenny
authors.initials: J
authors.lastname: García Valencia
authors.affiliation: Médico psiquiatra, Master en Farmacología. Profesor Universidad Nacional de Colombia, Bogotá, Colombia.
authors.forename: Luis Eduardo
authors.initials: LE
authors.lastname: Jaramillo González
authors.affiliation: Médico Servicio Social Obligatorio. Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: Mauricio J
authors.initials: MJ
authors.lastname: Ávila
authors.affiliation: Médico psiquiatra, psicoanalista, psiquiatra de enlace, magíster en Epidemiología Clínica. Profesor titular y Director del Departamento de Epidemiología Clínica y Bioestadística. Pontificia Universidad Javeriana. Hospital Universitario San Ignacio., Bogotá, Colombia. Electronic address: cgomez@javeriana.edu.co.
authors.forename: Carlos
authors.initials: C
authors.lastname: Gómez-Restrepo
authors.affiliation: Médico, Residente de Psiquiatría General, Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Arenas González
mesh_terms: D000328:Adult; D000380:Agranulocytosis / Q000139:chemically induced; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003024:Clozapine / Q000009:adverse effects / Q000627:therapeutic use*; D016903:Drug Monitoring / Q000379:methods; D006801:Humans; D007958:Leukocyte Count; D017410:Practice Guidelines as Topic; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D003024:Clozapine
keywords: Agranulocitosis; Agranulocytosis; Alteraciones hematológicas; Antipsicóticos; Antipsychotics; Clinical Practice Guidelines; Esquizofrenia; Guía de práctica clínica; Hematologic disorders; Schizophrenia