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Lithium Schizophrenia and related psychoses CHAPTER 1 Concurrent medications Different classes of medicines associated with haematological adverse effects are co-­ prescribed with clozapine. These include other antipsychotics, anticonvulsants such as sodium va...

Granulocyte colony-stimulating factor 270 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 Lithium does not protect against true clozapine-­induced agranulocytosis. One case of fatal agranulocytosis has occurred with this combination25 and a second...

References Schizophrenia and related psychoses CHAPTER 1 ■ ■Combined antipsychotic medications are commonly prescribed and this practice seems to be relatively resistant to change. ■ ■As a minimum requirement, all patients who are prescribed combined antipsych...

References Schizophrenia and related psychoses CHAPTER 1 G-­CSF in the face of a low or declining neutrophil count may mask an impending neutropenia or agranulocytosis, leading to dire consequences. The long-­term safety of G-­CSF has not been determined but b...

Clozapine and chemotherapy

Summary Schizophrenia and related psychoses CHAPTER 1 Clozapine and chemotherapy The use of clozapine with agents that cause neutropenia is formally contraindicated. Most chemotherapy treatments cause significant bone marrow suppression. When the white blood c...

References 274 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 ■ ■The likelihood of relapse or deterioration of the psychotic illness must be considered before discontinuing clozapine. ■ ■Consideration should be given to the possibility that, if t...

Genetic testing for clozapine treatment

Response

Agranulocytosis Schizophrenia and related psychoses CHAPTER 1 Genetic testing for clozapine treatment A great number of studies have sought to detect genetic predictors of clozapine outcomes, both therapeutic and adverse. Generally, only small effects have bee...

Benign ethnic neutropenia

Metabolism 276 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 HLA-­B59:01 Presence of allele highly predictive of agranulocytosis but is rare in East Asian populations and almost absent in people of European descent. Sensitivity 31.8%, specificit...

Other adverse effects

Antipsychotic prophylaxis

References Schizophrenia and related psychoses CHAPTER 1 NFIB rs28379954 T>C CT carriers have much lower blood concentrations than TT carriers in both smokers and non-­smokers.18 Also, the rs2472297 genotype independently predicts clozapine plasma levels.19 Le...

First episode of psychosis 28 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 Antipsychotic prophylaxis First episode of psychosis Antipsychotics provide effective protection against relapse, at least in the short to medium term,1 and the introduc...

Multi-episode schizophrenia

Summary Schizophrenia and related psychoses CHAPTER 1 a first admission for schizophrenia, clozapine and olanzapine fared better with respect to preventing readmission than other oral antipsychotics.23 In this same study, the use of a long-­acting antipsychoti...