title: Increase in white cell and neutrophil counts during the first eighteen weeks of treatment with clozapine in patients admitted to a long-term psychiatric care inpatient unit.
abstract: BACKGROUND
  Clozapine is an antipsychotic drug that has shown to be more effective than other antipsychotics in the treatment of schizophrenia, but its use is limited due to its side effects, particularly by the risk of causing agranulocytosis. A study was made on the variations in white cell and neutrophil counts in patients treated with clozapine in a Long-term Psychiatric Unit.
  
  
  METHODS
  A retrospective observational study was conducted with a sample of women of our long-term psychiatric care unit who had been treated with clozapine. A study was made on the variations in white cell and neutrophil counts during the first 18 weeks of treatment, as well as the onset of leukopenia, neutropenia, agranulocytosis, and the influence of concomitant drugs.
  
  
  CONCLUSIONS
  The study included 55 patients on treatment with clozapine. The incidence rate of neutropenia was 1.82% (95% CI; 0.05-10.13). The incidence rate of leukopenia and agranulocytosis was 0%. An increase in white cell and neutrophil counts from baseline to week 3-4 was observed. Only small variations were observed after this time, but the counts remained higher than the initial values. These changes were statistically significant in the white cell count: One-way repeated ANOVA with Greenhouse-Geisser correction F (11.47, 37) = 2.114 (P= .011); and in neutrophils: One-way repeated ANOVA with Greenhouse-Geisser correction F (10.3, 37)=3.312 (P=.0002), and MANOVA F (18, 37)=2.693 (P=.005), ŋ2P=0.567. The influence of concomitant drugs (lithium, valproic and biperiden) was not significant on the overall increase found in white cells or neutrophils (MANOVA).
authors.affiliation: Complejo Asistencial Benito Menni, Unidad de Cuidados Psiquiátricos Prolongados, Ciempozuelos, Madrid, España. Electronic address: adriancapllonch@gmail.com.
authors.forename: Adrián
authors.initials: A
authors.lastname: Capllonch
authors.affiliation: Complejo Asistencial Benito Menni, Unidad de Cuidados Psiquiátricos Prolongados, Ciempozuelos, Madrid, España.
authors.forename: Silvia
authors.initials: S
authors.lastname: de Pablo
authors.affiliation: Complejo Asistencial Benito Menni, Unidad de Cuidados Psiquiátricos Prolongados, Ciempozuelos, Madrid, España.
authors.forename: Alberto
authors.initials: A
authors.lastname: de la Torre
authors.affiliation: Complejo Asistencial Benito Menni, Unidad de Cuidados Psiquiátricos Prolongados, Ciempozuelos, Madrid, España.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Morales
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D003024:Clozapine / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D015994:Incidence; D007958:Leukocyte Count; D007970:Leukopenia / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D008137:Longitudinal Studies; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D015415:Biomarkers; D003024:Clozapine
keywords: Agranulocitosis; Agranulocytosis; Clozapina; Clozapine; Leucopenia; Leukopenia