[A case of leukopenia in treatment with risperidone in an adolescent]

The safety and efficacity of atypical antipsychotics in comparison with conventional neuroleptics allow their prescription in children and adolescents who are particularly at risk for developing neurological or cardiac side-effects. Hematological complications of new antipsychotics are less known, except for clozapine treatment in which blood monitoring strategy is well established. We report on a case of risperidone-associated leucopenia in an african adolescent treated for schizophrenia. He developed leucopenia 10 days after starting risperidone therapy (4 mg/day). The cessation of treatment was followed by a normalization of the white blood cell differential count and the rechallenge was positive (2 mg/day). No hematological abnormalities were observed with olanzapine therapy in this patient. Therefore olanzapine may represent a safe therapeutic alternative. We concluded that risperidone therapy may create a risk for leucopenia especially in patients who present a risk of leucopenia for ethnic reasons. We propose hematological monitoring during risperidone treatment.