Does clozapine affect neutrophils?

Clozapine is oxidized to a reactive nitrenium ion, (11) which covalently binds to neutrophils, (12) and it has been proposed that this reactive metabolite is responsible for the effects of clozapine on neutrophils.

Can clozapine cause high neutrophils?

The incidence of leukocytosis associated with clozapine has been reported rarely in the literature. We observed dose-dependent effect, rise of WBC count and neutrophil count was consistent with increase of clozapine dose, the count decreased proportionately and became normal when there was discontinuation of clozapine.

Why does clozapine cause neutropenia?

The mechanism by which clozapine induces neutropenia (CIN) and agranulocytosis (CIA) is still unclear but there is evidence it is caused by the activation of clozapine to a chemically reactive nitrenium ion, which could lead to neutropenia via direct toxicity, or by initiating an immune mechanism, or both.

How does clozapine affect ANC?

Unfortunately, the use of clozapine is limited by its potential for serious adverse effects, the most concerning of which is agranulocytosis, usually defined as a fall in the absolute neutrophil count (ANC) to<500/mm3. The mechanism by which clozapine leads to a drop in white blood cell (WBC) count is still unknown.

Can clozapine cause high WBC?

Unfortunately, clozapine is also associated with a number of adverse effects, with agranulocytosis being one of the chief concerns. Interestingly, patients who receive clozapine treatment may occasionally experience elevations in their total white blood cell count (WBC).

How does clozapine affect WBC?

Conclusion: Hematologic side effects are frequently induced by the atypical antipsychotic clozapine. Next to agranulocytosis, a progressive and potentially lethal hematologic adverse effect, most of the WBC disorders are transient and appear to be harmless.

What are the symptoms of clozapine toxicity?

Clozapine at toxic doses may cause hyperthermia, alterations in consciousness, seizures, cardiac arrhythmias, excessive mucus production in bronchi, hypersalivation, miosis, blood dyscrasias, pancreatitis and hepatitis (Sartorius et al., 2002).

What WBC count and ANC count is acceptable for a patient to have his WBC and ANC levels monitored every 2 weeks for 6 months and then every 4 weeks?

If acceptable WBC counts and ANC (WBC ≥3500/mm3 and ANC ≥2000/mm3) have been maintained during the year of weekly monitoring, WBC counts can be monitored every 2 weeks for the next 6 months.

How often does clozapine cause neutropenia?

CLOZAPINE AND AGRANULOCYTOSIS Neutropenia is seen in about 3%. The risk of both agranulocytosis and neutropenia is highest between 6 weeks and 18 weeks after starting clozapine treatment.

What to expect from Clozaril?

weight gain;

What is normal range for absolute neutrophils count?

A normal (absolute) neutrophil count is between 2500 and 7500 neutrophils per microliter of blood. 2  The neutrophil count may be high with infections, due to increased production in the bone marrow as with leukemia, or due to physical or emotional stress.

How to calculate the absolute neutrophil count (ANC)?

ANC calculation can be done in two ways: By using the value of WBC count: If doctors prescribed both WBC count as well as Absolute Neutrophil Count, then the formula is: multiply your white blood count (WBC) x total neutrophils (segmented neutrophils% + segmented bands%) x 10 = ANC.

What does the absolute neutrophil count mean?

Absolute neutrophil count: The real number of white blood cells (WBCs) that are neutrophils. The absolute neutrophil count is commonly called the ANC. The ANC is not measured directly. It is derived by multiplying the WBC count times the percent of neutrophils in the differential WBC count.