Haloperidol-related neutropenia

Area of Science:

• Pharmacology
• Hematology
• Psychiatry

Background:

• Neutropenia is a rare side effect of phenothiazine antipsychotics, with limited reports associated with haloperidol.
• A 20-year-old male presented with pneumonia and agitation, initially treated with moxifloxacin.
• The patient developed pneumothorax and behavioral issues, leading to consideration of a manic episode.

Observation:

• Haloperidol was administered for severe agitation and resistance to medical procedures.
• Following haloperidol initiation, a significant decrease in the patient's leukocyte count was observed.
• The patient required filgrastim (Neupogen) and blood transfusions for his neutropenia.

Findings:

• The patient's neutropenia was suspected to be drug-related, developing after haloperidol administration.
• Discontinuation of haloperidol and initiation of quetiapine resulted in the normalization of white blood cell counts.
• This case highlights a rare adverse drug reaction to haloperidol.

Implications:

• Clinicians should be vigilant for neutropenia in patients treated with haloperidol, especially those with pre-existing risk factors.
• Early detection and management, including drug-induced neutropenia protocols, are crucial.
• Alternative antipsychotic agents like quetiapine may be considered in patients experiencing adverse hematological effects.