Should clozapine be stopped if eosinophil count goes up and if clozapine is continued what are the likely adverse outcomes?
Hello Firdosi,
Clozapine, effective in resistant schizophrenia. However recently its focus has been shifted to eosinophilia. It has reported that clozapine-induced eosinophilia, count increased during the initial week of clozapine treatment after that started resolving gradually. Eosinophilia, though considered benign and transient, needs to be monitored in view of a possible association with life-threatening conditions like myocarditis and predictor of subsequent neutropenia.
Hello,
Good question, since the eosinophilia possible with Clozapine may be benign- or potentially even be associated with fatal events.
---------- INHN: Updated Practice Guidelines for the Use of Clozapine in Adult ...
inhn.org/.../updated-practice-guidelines-for-the-use-of-clozapine-in-adult-individuals-...by G Wegener - 2016 - Related articlesIt is important to pay attention to eosinophilia since it can be associated with more serious ADRs including polyserositis (Patel et al., 2012), myocarditis (Chatterton, 1997), and pancreatitis (Huang et al., 2009). 7.2.13. Abnormal Liver Tests. Elevations in liver enzyme are usually transitory during clozapine treatment (Erdogan ...
---------- A Guide to the Management of Clozapine- Related Tolerability and ...
www.clinicalschizophrenia.net/pdfs/Featured_Paper-Fall2016-Citrome.pdfby L Citrome - Cited by 9 - Related articlesClozapine is a highly effective antipsychotic medication, which provides a range of significant benefits for patients with schizophrenia, and is ..... is approximately 1.3% overall (26-28, 69), and is elevated in older patients ... Eosinophilia, leukocytosis, CAF, and tachycardia (provided that myocarditis and. NMS are ruled out).
---------- Clozapine induced eosinophilia: An often neglected important adverse ...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711251/by PK Kadiyala - 2015 - Cited by 5 - Related articlesSir,. Clozapine, though effective in resistant schizophrenia, needs extensive monitoring more than any drug in psychiatry. Initial concerns were mainly related to agranulocytosis, but in recent years the focus has been shifted to eosinophilia and its potentially fatal complications.[1,2]. Eosinophilia, a nondose-dependent ..
--------- Successful re-exposure to clozapine after eosinophilia and clinically ...
www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462013000100018by NM Granja-Ingram - 2013 - Cited by 8 - Related articlesWith a normal white blood cell count, absolute neutrophil count (ANC) and absolute eosinophil count (AEC), we initiated clozapine treatment at 25 mg twice per day. After 14 days of increasing treatment, the eosinophil count was elevated at 820/µL, and the patient reported shortness of breath and tachycardia. On day 21 ...
----------- Successful Rechallenge With Clozapine After Eosinophilia
https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.2010.10040519by CE Roberts - 2011 - Cited by 19 - Related articlespatients with elevated eosinophil counts without medical complaint. These reports concluded that eosinophilia was not necessarily a marker for medical illness, and no rec- ommendations were made regarding discontinuation of clozapine treatment in the presence of eosinophilia with- out associated somatic symptoms.
---------- Eosinophilia - Springer Link
https://link.springer.com/content/pdf/10.1007/978-3-319-51026-2_32.pdfby A Annamalai - 2017 - Related articlesEosinophilia. Eosinophilia refers to an absolute eosinophil count >500 cells/μL. A value >5000 cells/μL is considered severe eosinophilia. Pathology. Eosinophils are ... commonly, primary hematologic disorders cause elevations in eosinophils. Psychotropic ... antipsychotics and clozapine cause mild eosinophilia [1, 2].
https://www.pharmaceutical-journal.com//learning/learning-article/how-clozapine-patients-can-be-monitored-safely-and-effectively/11138788.fullarticle?firstPass=false