A second trial of clozapine in a case of granulocytopenia

It is generally believed that agranulocytosis, a major problem with clozapi ne treatment, will tend to occur dose-dependently once it develops in an in dividual. Therefore, despite clinical progress obtained, the drug has to be discontinued and treatment shifts to another drug. We report on the case o f a 29-year-old woman with DSM-IV undifferentiated schizophrenia who develo ped agranulocytosis after 5 years of 300 mg/day clozapine treatment. The dr ug was withdrawn and two trials with thioridazine and olanzapine were unsuc cessful. Four months after clozapine suspension, we decided to make a furth er trial, reintroducing clozapine titrated up to 500 mg/day. The patient's symptoms improved and blood leukocytes remained within the normal range aft er eight months. Copyright (C) 2000 John Wiley & Sons, Ltd.