Document Detail

High clozapine concentrations in leukocytes in a patient who developed leukocytopenia.
MedLine Citation:
PMID:  17467133     Owner:  NLM     Status:  MEDLINE    
Up to now direct toxic effects or immunological processes have been said to explain clozapine-induced agranulocytosis. However, more recent studies may suggest that not yet metabolized clozapine is taken up by leukocytes and transformed by oxidative processes to apoptosis-inducing metabolites. To verify this hypothesis the concentrations of clozapine were measured in the plasma and the leukocytes of a patient receiving clozapine who developed clozapine-induced leukocytopenia and in 10 patients receiving clozapine who did not show any serious adverse side effects. The patient who developed leukocytopenia showed clozapine concentrations in the leukocytes that were about 8 times higher than the mean clozapine concentrations in the leukocytes in the group of 10 patients receiving clozapine with no changes in the leukocyte count in the history. However, no major difference was found in the clozapine plasma concentrations. The results may suggest that patients at risk of developing clozapine-induced leukocytopenia show increased clozapine concentrations in the leukocytes although the clozapine plasma concentration is in the therapeutic range. It is assumed that changes or abnormalities of clozapine uptake at the cell membrane might play a role in the development of clozapine-induced leukocytopenia and/or agranulocytosis.
Niels Bergemann; Fatima Abu-Tair; Rolf Aderjan; Jürgen Kopitz
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2007-03-23
Journal Detail:
Title:  Progress in neuro-psychopharmacology & biological psychiatry     Volume:  31     ISSN:  0278-5846     ISO Abbreviation:  Prog. Neuropsychopharmacol. Biol. Psychiatry     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-31     Completed Date:  2007-08-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211617     Medline TA:  Prog Neuropsychopharmacol Biol Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  1068-71     Citation Subset:  IM    
Department of General Psychiatry, University of Heidelberg Voss-Str 4, Heidelberg, Germany.
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MeSH Terms
Agranulocytosis / blood,  chemically induced
Antipsychotic Agents / adverse effects*,  blood*
Clozapine / adverse effects*,  blood*
Leukocyte Count
Leukocytes / drug effects,  metabolism*
Leukopenia / blood*,  chemically induced*
Middle Aged
Psychotic Disorders / blood,  complications
Reg. No./Substance:
0/Antipsychotic Agents; 5786-21-0/Clozapine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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