Understanding clozapine-related blood dyscrasias. Developments, genetics, ethnicity and disparity: it's a CIN

Silva, Edward, Legge, Sophie, Casetta, Cecilia, Whiskey, Eromona, Oloyede, Ebenezer and Gee, Siobhan 2024. Understanding clozapine-related blood dyscrasias. Developments, genetics, ethnicity and disparity: it's a CIN. BJPsych Bulletin 49 (3) , pp. 163-168. 10.1192/bjb.2024.38

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Abstract

Clozapine remains the gold standard intervention for treatment-resistant schizophrenia; however, it remains underused, especially for some minority groups. A significant impediment is concern about propensity to neutropenia. The aim of this article is to provide an update on current knowledge relating to: the pattern and incidence of severe blood dyscrasias; the effectiveness of current monitoring regimes in reducing harm; the mechanisms of and the distinctions between clozapine-induced neutropenia and agranulocytosis; benign ethnic neutropenia; and changes to the monitoring thresholds in the USA and other international variations. These all have implications for the practical use of clozapine; specifically, how barriers to initiating, maintaining and restarting clozapine can be understood and in many cases overcome, especially for patients from minority groups, potentially with simpler approaches than the use of lithium or G-CSF.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Schools > Medicine
Additional Information:	License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by/4.0/, Type: open-access
Publisher:	Royal College of Psychiatrists
ISSN:	2056-4694
Date of First Compliant Deposit:	18 June 2025
Date of Acceptance:	5 April 2024
Last Modified:	18 Jun 2025 10:15
URI:	https://orca.cardiff.ac.uk/id/eprint/179156

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