Paliperidone induced neutropenia in first episode psychosis: a case report

BMC Psychiatry

William Hall¹  Alicia Marhefka¹  Frederick C. Nucifora¹  Thomas W. Sedlak¹  Natalie Martos¹ 

[1] Deptments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, 21287, Baltimore, MD, USA;

关键词: First episode psychosis;    Neutropenia;    Paliperidone;    Schizophrenia;    Clozapine;   

DOI  :  10.1186/s12888-021-03073-w

来源: Springer

【 摘 要 】

BackgroundNeutropenia, a decrease in total number of neutrophils below 1500/mm3 and particularly severe neutropenia, defined as neutrophils less than 500/mm3, is a potential adverse effect of antipsychotic medications that can lead to increased risk of infections and death. However, much of the attention on the potential adverse effect is centered exclusively on clozapine, which remains the only antipsychotic medication in the United States requiring standardized monitoring of blood work. We demonstrate here that paliperidone can also cause neutropenia and therefore clinicians should be aware of this possibility especially during initiation of treatment.Case presentationThe following report presents the case of a 23-year-old African American male with first episode psychosis who developed neutropenia after initiation of paliperidone. Neutropenia resolved after discontinuation of paliperidone and initiation of an alternative antipsychotic, haloperidol.ConclusionsThis case report demonstrates an example of paliperidone induced neutropenia which resolved with a switch to haloperidol. We conclude that when initiating paliperidone, clinicians should be more aware of the risk of neutropenia. Moreover, neutropenia may be a more common and overlooked issue in patients on antipsychotic medications other than clozapine and increased awareness of comparative risk across antipsychotics could help direct treatment.

【 授权许可】

CC BY