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Need to bleed? Clozapine haematological monitoring approaches a time for change

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Eromona Whiskey, Olubanke Dzahini, Rosalind Ramsay, David O'Flynn, Aleksandar Mijovic, Fiona Gaughran, James MacCabe, Sukhi Shergill, David M. Taylor

Original languageEnglish
Pages (from-to)264-268
Number of pages5
JournalInternational Clinical Psychopharmacology
Issue number5
Early online date14 Mar 2019
Accepted/In press25 Feb 2019
E-pub ahead of print14 Mar 2019
Published1 Sep 2019


King's Authors


Regular haematological monitoring during clozapine treatment reduces the risk of complications and death from clozapine-related blood dyscrasias. However, many patients in the course of clozapine treatment develop neutropenia unrelated to drug treatment which leads to treatment discontinuation. The minimum haematological threshold allowed for the continuation of clozapine treatment was recently lowered in the US, but not in the UK. In this case series, we present four cases where lowering the haematological cut-off to that used in the US, allowed treatment continuation. Lowering the current UK threshold for clozapine cessation could avoid unnecessary interruptions in treatment with minimal impact on safety.

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