HEMATOLOGICAL TOXICITY OF PSYCHOTROPIC MEDICATIONS: A CASE REPORT

Hematological toxicity can be clinically important during psychotropic treatment. We present the case of a 40-year-old Guinean man with schizoaffective disorder who developed neutropenia and leukopenia after starting chlorpromazine (300 mg/day), and a second neutropenic episode under carbamazepine (800 mg/day). He had never been treated with antipsychotics before. Then a first hematological abnormality appeared ten days after initiating chlorpromazine, and the second episode occurred three weeks after introducing carbamazepine. In these situations, cessation of the suspected drug led to rapid normalization of hematological values. These events were reported to the pharmacovigilance center, and these medications were formally contraindicated for our patient. Chlorpromazine and mood stabilizers like carbamazepine are known causes of leukopenia and agranulocytosis, in this case , ethnic neutropenia was initially considered but the clear temporal association between drug exposure and hematological abnormalities supported a diagnosis of drug-induced neutropenia. This case illustrates the importance of systematic blood count monitoring when initiating psychotropic drugs known to cause hematologic adverse effects.