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Q: Clozapine & Low White Blood Cell Count
asked by: PC5149 on May 12th, 2008
New User
Hi

My 16 year old has been recently diagnosed with schizophrenia and has been extremely ill since November although she is improving slowly now.

She is on a cocktail of drugs including clozapine which worked very well when first introduced and she seemed to almost make a miraculous recovery.

At about 9 weeks into the clozapine treatment she was up to 300mg/day when her WBC and Neutrophil count dropped into the red zone.

After coming off the clozapine as required by Australian protocols she then recommenced treatment with very slow increases back up to 75mg/day where she has remained for several months due to her WBC and Neutrophil count remaining in the Amber zone.

This dosage appears to be holding her stable but not enabling further progress (she continues to experience psychosis).

I would be appreciative of any suggestions or information anyone has to offer regarding known strategies for increasing the WBC and Neutrophil count.

The only thing that has been tried so far is the introduction of Lithium and the cessation of several ancillary medications, none of which appears to be working.

I would also be interested in hearing about anyone who has had a similar experience and what outcome was achieved.

Regards
PC5149
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CarolDiane
replied on June 25th, 2008
Extremely eHealthy
I was changed from Lithium to Depekote ans Seroquil and doing fine now. I an allergic to Lithuim. Bipolar meds are notorious for lowering your WBC from what I have heard. I have my labs done again in three weeks. Last time on Lithium it was just slightly low. But I have a low immune system anyway and can not afford to go to much lower. I really don't think there is anyway to up the level other then IV infusion.
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intiqurashi
replied on January 20th, 2009
New User
Hi,

I am a Consultant Forensic |psychiatrist working In United Kingdom. My patients include a high proportion requiring Clozapine. I agree that it can have a massive clinical response as in your child's case restoring awreness and social functioning.

One option, an alternative to Lithium, (this is going out of fashion as it may 'mask' an imminent fall in WCC) is to use Granulocyte colony stimulating factor. I ahev used this as a measure of last resort with good effect. It is used widely by haematologists, is safe (although expensive). Your childs psychiatrist may have little, if any , experience of using this and would need to seek advice from a consultant haematologist.

You also do not state whether your child is of black descent. this is importnat as again the reference range for WCC ranges in certain ethnic poulations are set lower than white populations to take into consideration naturally low white cell counts (WCC). If this is the case then the red result may have been 'artificial'.

I hope this is of some use.

i suggest google clozapine and G-CSF.
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