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Need to bleed? Clozapine haematological monitoring approaches a time for change

Eromona Whiskey1,2,3, Olubanke Dzahini2,3, Rosalind Ramsay1,4

  • 1National Psychosis Service, South London and Maudsley NHS Foundation Trust.

International Clinical Psychopharmacology
|March 19, 2019
PubMed

Regular haematological monitoring during clozapine treatment reduces the risk of complications and death from clozapine-related blood dyscrasias. However, many patients in the course of clozapine treatment develop neutropenia unrelated to drug treatment which leads to treatment discontinuation. The minimum haematological threshold allowed for the continuation of clozapine treatment was recently lowered in the US, but not in the UK. In this case series, we present four cases where lowering the haematological cut-off to that used in the US, allowed treatment continuation. Lowering the current UK threshold for clozapine cessation could avoid unnecessary interruptions in treatment with minimal impact on safety.

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