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Loxapine and Cyproheptadine Combined Limit Clozapine Rebound Psychosis and May Also Predict Clozapine Response.

Aboueid L, McCarthy RH - Case Rep Psychiatry (2016)

Bottom Line: Clozapine has been consistently shown to be superior to other antipsychotics in the treatment of psychosis.However, clozapine usage has been limited due to required routine blood monitoring and the potential for life threatening side effects.We report a case of a 66-year-old female patient, who developed clozapine-induced agranulocytosis after 10 weeks of clozapine treatment and was subsequently successfully treated with a combination of loxapine and cyproheptadine.

View Article: PubMed Central - PubMed

Affiliation: SUNY Downstate Medical Center, Department of Psychiatry, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.

ABSTRACT
Clozapine has been consistently shown to be superior to other antipsychotics in the treatment of psychosis. However, clozapine usage has been limited due to required routine blood monitoring and the potential for life threatening side effects. We report a case of a 66-year-old female patient, who developed clozapine-induced agranulocytosis after 10 weeks of clozapine treatment and was subsequently successfully treated with a combination of loxapine and cyproheptadine. The combination is thought to mimic the pharmacological profile of clozapine, rendering it as a possible alternative to traditional clozapine treatment.

No MeSH data available.


Related in: MedlinePlus

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Mentions: Initially, hypotension limited dose increases, but at ten weeks she had a precipitous drop in her white blood cells (WBC) and absolute neutrophil count (ANC) (Figure 1) that proceeded to full blown agranulocytosis over a three-day period. Filgrastim treatment was begun; clonazepam was used to contain anxiety and the patient was started on cyproheptadine 4 mg TID to prevent clozapine discontinuation rebound psychosis. When the patient's hematological indices returned to normal, the patient was begun on loxapine 10 mg daily to address her newly returned paranoid delusions. Over the next three weeks, the patient's delusions continued to decrease to levels lower than they had been on clozapine. At this time, about two years after clozapine discontinuation, the delusions are only minimally present and do not result in any interference in the patient's daily life.


Loxapine and Cyproheptadine Combined Limit Clozapine Rebound Psychosis and May Also Predict Clozapine Response.

Aboueid L, McCarthy RH - Case Rep Psychiatry (2016)

© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940529&req=5

Mentions: Initially, hypotension limited dose increases, but at ten weeks she had a precipitous drop in her white blood cells (WBC) and absolute neutrophil count (ANC) (Figure 1) that proceeded to full blown agranulocytosis over a three-day period. Filgrastim treatment was begun; clonazepam was used to contain anxiety and the patient was started on cyproheptadine 4 mg TID to prevent clozapine discontinuation rebound psychosis. When the patient's hematological indices returned to normal, the patient was begun on loxapine 10 mg daily to address her newly returned paranoid delusions. Over the next three weeks, the patient's delusions continued to decrease to levels lower than they had been on clozapine. At this time, about two years after clozapine discontinuation, the delusions are only minimally present and do not result in any interference in the patient's daily life.

Bottom Line: Clozapine has been consistently shown to be superior to other antipsychotics in the treatment of psychosis.However, clozapine usage has been limited due to required routine blood monitoring and the potential for life threatening side effects.We report a case of a 66-year-old female patient, who developed clozapine-induced agranulocytosis after 10 weeks of clozapine treatment and was subsequently successfully treated with a combination of loxapine and cyproheptadine.

View Article: PubMed Central - PubMed

Affiliation: SUNY Downstate Medical Center, Department of Psychiatry, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.

ABSTRACT
Clozapine has been consistently shown to be superior to other antipsychotics in the treatment of psychosis. However, clozapine usage has been limited due to required routine blood monitoring and the potential for life threatening side effects. We report a case of a 66-year-old female patient, who developed clozapine-induced agranulocytosis after 10 weeks of clozapine treatment and was subsequently successfully treated with a combination of loxapine and cyproheptadine. The combination is thought to mimic the pharmacological profile of clozapine, rendering it as a possible alternative to traditional clozapine treatment.

No MeSH data available.


Related in: MedlinePlus