Lithium carbonate as a treatment for paliperidone extended-release-induced leukopenia and neutropenia in a patient with schizoaffective disorder; a case report

BMC Psychiatry. 2016 May 26:16:161. doi: 10.1186/s12888-016-0874-x.

Abstract

Background: Antipsychotic drug treatment can potentially lead to adverse events such as leukopenia and neutropenia. Although these events are rare, they represent serious and life-threatening hematological side effects.

Case presentation: We present a case study of a patient with schizoaffective disorder in a 50-year-old woman. We report a case of paliperidone extended-release (ER)-induced leukopenia and neutropenia in a female patient with schizoaffective disorder. Initiating lithium carbonate treatment and decreasing the dose of valproic acid improved the observed leukopenia and neutropenia. This treatment did not influence psychotic symptoms.

Conclusion: The combination of paliperidone ER and valproic acid induces increased paliperidone ER plasma levels. Lithium carbonate was successfully used to treat paliperidone ER-induced leukopenia and neutropenia.

Keywords: Leukopenia; Lithium carbonate; Neutropenia; Paliperidone extended-release; Schizoaffective disorder; Schizophrenia; Valproic acid.

Publication types

  • Case Reports

MeSH terms

  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Delayed-Action Preparations / administration & dosage
  • Delayed-Action Preparations / adverse effects*
  • Delayed-Action Preparations / therapeutic use
  • Female
  • Humans
  • Leukopenia / chemically induced
  • Leukopenia / drug therapy*
  • Lithium Carbonate / therapeutic use*
  • Middle Aged
  • Neutropenia / chemically induced
  • Neutropenia / drug therapy*
  • Paliperidone Palmitate / administration & dosage
  • Paliperidone Palmitate / adverse effects*
  • Paliperidone Palmitate / therapeutic use
  • Psychotic Disorders / drug therapy*
  • Treatment Outcome

Substances

  • Antipsychotic Agents
  • Delayed-Action Preparations
  • Lithium Carbonate
  • Paliperidone Palmitate