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Safety of a Clozapine Trial Following Quetiapine-Induced Leukopenia: A Case Report

[ Vol. 14 , Issue. 1 ]


Asma H. Almaghrebi *   Pages 80 - 83 ( 4 )


Background: The clozapine-derivative quetiapine has been shown in some cases to cause leukopenia and neutropenia.

Case Presentation: We reported on a case of a young female diagnosed with treatment-resistant schizophrenia. After failed trials of three antipsychotic medications and despite a history of quetiapineinduced leukopenia, clozapine treatment was introduced due to the severity of the patient’s symptoms, the limited effective treatment options, and a lack of guidelines on this issue.

Result: Over a ten-week period of clozapine treatment at 700 mg per day, the patient developed agranulocytosis. Her white blood cell count sharply dropped to 1.6 × 109 L, and her neutrophils decreased to 0.1 × 109 L. There had been no similar reaction to her previous medications (carbamazepine, risperidone, and haloperidol).

Conclusion: The safety of clozapine in a patient who has previously experienced leukopenia and neutropenia with quetiapine requires further investigation. Increased attention should be paid to such cases. Careful monitoring and slow titration are advisable.


Clozapine, quetiapine, leukopenia, neutropenia, agranulocytosis, schizophrenia.


Saudi Commission for Health Specialties, Psychiatry Speciality, Riyadh

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