Past Issues

Risperidone-induced Leukopenia and Neutropenia

Chih-Yuan Hung, Ya-Mei Bai

Background: Risperidone tends to have a lower risk of hematotoxicity. Here,
we report a woman patient who developed risperidone-induced neutropenia. Case
Report: A 64-year-old female patient with a diagnosis of bipolar disorder had received
several antipsychotics previously, without a history of neutropenia or leucopenia.
During a depressive episode with psychotic feature, she received risperidone
3.5 mg/day, lamotrigine 100 mg/day, and valproic acid 1,000 mg/day. Four
weeks later, she had leukopenia (white blood cells [WBC]: 2900/mm3) and neutropenia
(1,131/mm3) were noted in the regular laboratory test. Initially we suspected
the lamotrigine was related to the neutropenia and discontinued it, and increased
risperidone to 5 mg/day. Five days later, the neutrophil was further decreased to
1,015/mm3, so we discontinued risperidone and switched risperidone to 5 mg/day
to sulpiride 600 mg/day. Twelve days later, the WBC and differential count were
returned to normal limits. Conclusion: This is the fi rst report of risperidone-induced
leukopenia and neutropenia in Taiwan.
Key Word risperidone, leucopenia, neutropenia, blood dyscrasias
Editorial Committe, Taiwanese Journal of Psychiatry
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