How would you treat psychotic symptoms in a patient with atypical psychotic-induced leukopenia with absolute neutrophil count (ANC) below 500 cells/µL (<0.5 x 10^9 L)?
Given this has been seen in risperidone, quetiapine, olanzapine, and aripiprazole, do you typically avoid these as alternatives? What about newer atypicals or switching to typicals? When do you choose to trial adding lithium?
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Other than clozapine, which antipsychotics have you seen associated with leukopenia?
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3 Answers
Mednet Member
Psychiatry · Thapar Renu K Office
Answered on
I have not been faced with that situation except on Clozaril. I will use benzodiazepines initially to control anxiety and reduce the stress with psychotic symptoms. Later, when the white count starts to improve, I will initiate a different drug. Will go slow and check counts often enough not to miss...
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Mednet Member
Psychiatry · Neuropsychiatry Service
Answered on
The safest one to replace an antipsychotic will be haloperidol and lurasidone.
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Mednet MemberInvited Expert
Psychiatry · South Broward Hospital District
Answered on
Diagnosis? Age? BMI?
These are things I always take into account, but not having any details, I would say Haldol and lithium.
Also, see if there is any BEN.
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