Antipsychotics-induced leukopenia and neutropenia: A case report and review of literature

2016 ◽  
Vol 33 (S1) ◽  
pp. S546-S546 ◽  
Author(s):  
H. Maatallah ◽  
H. Ben Ammar ◽  
M. Said ◽  
A. Aissa
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Atypical Antipsychotics ◽  
Antipsychotic Drugs ◽  
Psychotic Symptoms ◽  
Review Of Literature ◽  
Blood Cell Count ◽  
Life Threatening ◽  
Dsm Iv ◽  
Competing Interest

IntroductionAntipsychotic drugs effectively control psychotic symptoms, but may cause important side effects, significantly increasing morbidity and mortality. Hematologic abnormalities are frequent and may be life-threatening in some patients. Many prospective investigations confirmed neutropenia as a frequent occurrence with virtually all atypical antipsychotics.Objective and methodsDefine epidemiological, clinical and therapeutic characteristics of antipsychotics – induced leukopenia and neutropenia through a case report and a review of literature.Case reportPatient 28 years old native of Tunis, with family history: brother who suffer of undifferentiated schizophrenia. Since the age of 16 years he has been followed for disorganized schizophrenia (DSM IV). He was initially put under Haldol Decanoate (2 months), fluphenazine (2 months), amisulpride (3 months), sulpride (2 months), olanzapine (3 months), Rispreridone (1 month), aripiprazole (5 months) leukopenia/neutropenia is occurring during treatment with each molecule and which promptly resolved after discontinuation. Reduced white blood cell count has also been reported after addition of lithium. Actually an ECT is proposed for this patient.ConclusionThis case report shows the importance of hematological monitoring during the course of typical or atypical treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals RISPERIDONE INDUCED LEUCOPENIA AND NEUTROPENIA: A CASE REPORT AND BRIEF REVIEW OF LITERATURE

2021 ◽  
Vol 9 (02) ◽  
pp. 724-726
Author(s):  
M. Berghalout ◽  
◽  
A. Ait Idar ◽  
H. Guennouni ◽  
K.El Ouazzani ◽  
...  
Keyword(s):  
Case Report ◽  
Antipsychotic Drugs ◽  
Early Recognition ◽  
Case Reports ◽  
Review Of Literature ◽  
Blood Cell Count ◽  
Small Minority ◽  
Hematological Effects ◽  
Life Threatening ◽  
Hematological Abnormalities

Hematological abnormalities are frequently encountered during treatment with antipsychotic drugs. Most of these are mild and of no clinical significance, but in a small minority of patients, hazardous, potentially life-threatening hematological effects, including leucopenia, neutropenia, agranulocytosis, thrombocytopenia, anaemia , leucocytosis, thrombocytosis, eosinophilia and altered platelet function. (1). Clozapine is associated with several well-known abnormalities of blood cell count (2), but some case reports associate novel antipsychotics, such as risperidone with leucopenia and agranulocytosis (3). This report describes a case of leucopenia under treatment with Oral Risperidone , suggesting the necessity of early recognition of leucopenia in order to prevent occurrence of potentially life-threatening agranulocytosis. ( 1) .

scholarly journals Olanzapine-induced leucopaenia and thrombocytopaenia in an elderly patient: a case report and review of the evidence

2018 ◽  
Vol 31 (2) ◽  
pp. e000013 ◽  
Author(s):  
Yogender Kumar Malik ◽  
Swapnajeet Sahoo ◽  
Ajit Avasthi
Keyword(s):  
Elderly Patient ◽  
Case Report ◽  
Side Effects ◽  
Case Reports ◽  
The Elderly ◽  
Elderly Individual ◽  
Psychotic Symptoms ◽  
Elderly Individuals ◽  
Second Generation Antipsychotics ◽  
Life Threatening

Haematological adverse effects of antipsychotics are rare but life threatening. Existing literature is limited to case reports, which are mostly reported on second generation antipsychotics (clozapine, olanzapine, risperidone, quetiapine). Elderly individuals are at risk of developing side effects with any psychotropics. Olanzapine is commonly used for the management of psychotic symptoms as well as for the management of behavioural and psychological problems with dementia in the elderly. In this case report, we report thrombocytopaenia and leucopaenia in an elderly individual with schizophrenia which developed after initiation of olanzapine and reverted back after stoppage of the drug. This case report highlights that the elderly are susceptible to develop haematological side effects with olanzapine and hence monitoring may be essential.

OLANZAPINE INDUCED AMENORRHEA REVERSED BY SWITCHING TO ARIPIPRAZOLE- A RARE CASE REPORT

2021 ◽  
pp. 50-51
Author(s):  
Ankit Halder ◽  
Navna Panchami ◽  
Abhishek Das
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Rare Case ◽  
Atypical Antipsychotics ◽  
Extrapyramidal Side Effects ◽  
Rare Case Report

Due to less extrapyramidal side-effects ,atypical antipsychotics use in psychiatry has increased a lot. But it is associated with other metabolic and endocrine side effects. Olanzapine is one such antipsychotic that less likely to cause hyperprolactinemia which can present as amenorrhea in patients.Here we present a rare case of olanzapine induced amenorrhoea reversed by switching to Aripiprazole.

scholarly journals Sudden bradycardia and impending cardiac arrest by intra-myometrial vasopressin in laparoscopic myomectomy: a case report and review of literature

2020 ◽  
Vol 9 (12) ◽  
pp. 5154
Author(s):  
Monika Madaan ◽  
Priyanka Baghotia ◽  
Neha Soni ◽  
Samir Shankar Raj
Keyword(s):  
Cardiac Arrest ◽  
Case Report ◽  
Side Effects ◽  
Blood Loss ◽  
Laparoscopic Myomectomy ◽  
Review Of Literature ◽  
Severe Bradycardia ◽  
Cardiovascular Side Effects ◽  
Decrease Blood Loss

Vasopressin has long been used in myomectomy to decrease blood loss. Its efficacy is beyond doubt. But at the same time it is known to cause some of the serious cardiovascular side effects. We here report a case of severe bradycardia and impending cardiac arrest caused by intra-myometrial infiltration of 12 U of vasopressin and present a review of literature.

Psychopharmacology

2014 ◽  
Author(s):  
Kazuya Iwata
Keyword(s):  
Dopamine Receptors ◽  
Side Effect ◽  
Atypical Antipsychotics ◽  
Synaptic Cleft ◽  
Psychotic Symptoms ◽  
Common Side Effect ◽  
Physical Treatment ◽  
Life Threatening ◽  
Autonomic Disturbances ◽  
Therapeutic Doses

Psychotropic drugs are the main form of physical treatment in psychiatry and they exert their action by mainly acting on dopamine, noradrenaline, serotonin, and muscarinic receptors. Antipsychotics, which are the mainline treatment for psychotic ill­nesses, usually act by blocking dopamine receptors in the dopamine pathways of the brain, usually the mesolimbic system. The D2 receptors are the usual target of the antipsychotics, although clozapine, which is considered the gold standard antipsychotic, has a strong affinity for the D4 receptors. The underlying principle of antipsychotic treatment builds on the dopamine theory of schizophrenia, whereby an excess of dopa­mine is linked to the development of psychotic symptoms. Overactive dopamine receptors are thought to be involved in this, and thus block­age of the dopamine receptors through antipsychotics can provide relief from psychotic symptoms. Antipsychotics are divided into typical and atypical, and the defining feature of typicals is their propensity to cause EPSEs. This is thought to be due to the fact that typical antipsychotics are not specific for dopa­mine receptors in the mesolimbic pathways, but can also block those in mesocortical, tuberoinfundibular, and nigrostriatal pathways. Atypical antipsychotics can impact on a variety of receptor types, such as serotonin, and thus they are usually subclassified according to their pharmacological properties. Their heterogeneous pharmacodynamics in part explains their variable side-effect profile. One common side-effect of atypical antipsychotics is their tendency to trigger metabolic syndrome, which is a cluster of cardiovascular risk factors including dyslipidaemia, hypertension, central obesity, and impaired glucose tolerance. They also cause endocrine-related side-effects, such as hyperprolactinaemia. An important adverse effect seen with any antipsychotic is neuroleptic malignant syndrome (NMS), which is an idiosyncratic reaction to antipsy­chotics taken even at therapeutic doses. Patients can present with hyper­thermia, rigidity, autonomic disturbances, and altered mental state over 24–48 hours. It can be potentially life threatening, and thus, if suspected, urgent referral to a general hospital is required. Antidepressants also vary greatly with regards to their pharmacologi­cal properties, but the majority increase the concentration of neuro­transmitters in the synaptic cleft to alleviate depressive symptoms.

Delirium on clozapine: A tale of friend turned foe-A case report

2020 ◽  
pp. 009121742097282 ◽  
Author(s):  
Aparna Das ◽  
Rebecca Minner ◽  
Lewis Krain ◽  
John Spollen
Keyword(s):  
Case Report ◽  
Clinical Practice ◽  
Side Effects ◽  
Adverse Effects ◽  
Older Adult ◽  
Psychiatric Illness ◽  
Management Strategies ◽  
Treatment Resistant ◽  
Drug Of Choice ◽  
Life Threatening

Treatment resistant schizophrenia (TRS) is often encountered in clinical practice. Clozapine remains the drug of choice in the management of TRS. Several studies have shown that clozapine is the most effective antipsychotic medication to date for TRS. But it is also well known that it has multiple side effects. Some side effects are transient and relatively benign, while other adverse effects are menacing, serious and life-threatening. Delirium may occur with clozapine and is a therapeutic challenge as there is always a risk of precipitating delirium on clozapine rechallenge. Limited management strategies are available as alternatives for the management of psychiatric illness stabilized on clozapine. In this case report, we describe an older adult patient who developed delirium on clozapine. The aims of this case report are to discuss the mechanism by which clozapine leads to delirium, revisit various factors which could possibly lead to delirium, and discuss the different management strategies available for management of psychiatric illness for a patient previously stabilized on clozapine.

scholarly journals Hemorrhagic Pseudocyst of Pancreas Treated with Coil Embolization of Gastroduodenal Artery: A Case Report and Review of Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Sudhir Kumar Jain ◽  
Vishnuraja Rajendran ◽  
Maneesh K. Jain ◽  
Ronal Kori
Keyword(s):  
Acute Pancreatitis ◽  
Case Report ◽  
Ct Angiography ◽  
Coil Embolization ◽  
Gastroduodenal Artery ◽  
Gi Bleeding ◽  
Review Of Literature ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Life Threatening

Hemorrhage into pseudocyst of pancreas can rarely present as life threatening massive UGI bleeding. We present a case of 21-year-old male, admitted to our department, who was a known case of posttraumatic acute pancreatitis and who developed massive upper GI bleeding. CT angiography of abdomen showed aneurysm of gastroduodenal artery. Patient was successfully treated with coil embolization of gastroduodenal artery.

Electroconvulsive therapy in schizophrenia – where do we stand?

2016 ◽  
Vol 33 (S1) ◽  
pp. s262-s263
Author(s):  
J. Silva ◽  
J. Mota ◽  
P. Azevedo
Keyword(s):  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Severe Depression ◽  
Psychotic Symptoms ◽  
Drug Intolerance ◽  
Rapid Control ◽  
Practice Of Medicine ◽  
Nice Guidance ◽  
Schizophrenic Patients ◽  
Competing Interest

IntroductionElectroconvulsive therapy is currently used in the management of severe depression, long-term mania and catatonia. Regarding schizophrenia-related psychosis ECT is also an option, but the indication is restrictive to severe cases, drug intolerance or resistant ones. Lack of evidence of cost-effectiveness compared to clozapine, and side effects of ECT techniques before 2003, influenced NICE guidance to not recommend ECT in schizophrenia, but modern ECT machines and procedures are subsequent to 2003. ECT is often performed when clozapine fails to respond in monotherapy or if there is intolerance to antipsychotic side effects. ECT in combination with clozapine seems to have significant results allowing the patients to achieve rapid control of psychotic symptoms with fewer side effects, comparing with antipsychotics-association strategies.ObjectivesTo summarized the latest literature about this field and to present recent data from the Electrovulsivetherapy Unit, in Hospital de Magalhães Lemos, Portugal.AimTo explore and critically review the controversies of electroconvulsive therapy in the management of drug-resistant schizophrenia.MethodsRetrospective data of an Electroconvulsive Therapy Unit during 2006–2015 was review.Results198 ECT treatments in schizophrenic patients were performed in our unit, during 2006–2007, in a total of 647 ECT (30,6%). In 2014–2015, 945 schizophrenic patients received ECT treatment, in a total of 2149 performed ECT (43,9%).ConclusionsAlthough guidelines are crucial for the uniform practice of medicine, sometimes is important to be critical about them. The use of ECT in schizophrenia is safe and effective and further research is needed to continue to support this treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Culture and mental disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S517-S517
Author(s):  
A. Adrián ◽  
C. Noval Canga ◽  
H. Rebeca ◽  
S. Isabel ◽  
G. Sofía ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Mental Disorders ◽  
Psychiatric Diagnosis ◽  
Emergency Service ◽  
Psychotic Symptoms ◽  
Sociocultural Factors ◽  
Psychiatric History ◽  
Sexual Content ◽  
Competing Interest

ObjectivesShow with a case report how psychiatric pathology may face differential diagnosis problems when sociocultural aspects are involved.Methods and materialsSeventy-three year old man, born in Colombia. During the last two months, he had come many times to the emergency service due to behavioural changes. He does not have previous psychiatric history. His daughter refers that one of the patient's sisters has been diagnosed of “mystical madness”. The previous days he abandoned his medical treatment saying that he “gets in touch with his wife and that he wants to meet her”. Since his wife's dead, he had presented an excessively adapted behaviour, without grief symptoms. The first hospitalization day he said we wanted to get married with one of his daughters, with a sexual content speech, being able to get emotional when he spoke about his dead wife. Now the patient is under frequent reviews, and it is thought the differential diagnosis of depression with psychotic symptoms, due to the lack of symptoms remission.ConclusionWhenever we face different psychiatric diagnosis we don’t keep in mind some sociocultural factors, which could be masked and raise different doubts. It is important to keep in mind that each country or ethnical have their own cultural habits which are going to deeply influence patient's personality.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Fatal hyperkalemia following succinylcholine administration in a child on oral propranolol

2015 ◽  
Vol 30 (1) ◽  
Author(s):  
Anuradha Ganigara ◽  
Chandrakala Ravishankar ◽  
Chandrika Ramavakoda ◽  
Madhavi Nishtala
Keyword(s):  
Drug Interaction ◽  
Case Report ◽  
Side Effects ◽  
Drug Combination ◽  
Neuromuscular Block ◽  
Severe Effect ◽  
Adrenergic Blocker ◽  
Life Threatening ◽  
Adrenergic Blockers ◽  
Oral Propranolol

AbstractSuccinylcholine is one of the most commonly used drugs by anesthesiologists worldwide for rapid access to airway both in emergency and elective situations. Nonetheless, the very mention of succinylcholine generates the most energetic high decibel debate between its users and nonusers. Despite its potential to produce a short-acting, ultra-intense neuromuscular block rapidly in seconds, it is surrounded by a plethora of side effects and drug interactions. This case report is about one such drug interaction of this innocent yet malicious drug, which resulted in the death of a 14-year-old girl. Both β-adrenergic blockers and succinylcholine are known to cause hyperkalemia. Life-threatening hyperkalemia in susceptible individuals who have been administered succinylcholine has the most severe effect on the myocardium and can result in asystole with minimal chances of resuscitation. Both succinylcholine and a nonselective β-adrenergic blocker, propranolol, have the propensity to affect the transcellular redistribution of potassium which can result in hyperkalemia. We advocate cautious use of this drug combination till further studies confirm the drug interaction and find the potential triggering factors involved.

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