ABSTRACT
Neutropenia and agranulocytosis are dangerous conditions seldom caused by antipsychotics. We report the case of a 35-year-old female patient who presented with neutropenia following ziprasidone administration. Ziprasidone was gradually increased to 160 mg/day in combination with escitalopram 10 mg/day. Following ziprasidone administration, her neutrophil count fell to 1700x10(3)/mm3, on day 45 and to 1500x10(3)/mm3 on day 57. Ziprasidone was immediately stopped, and quetiapine 25 mg was given from the next day onward, along with the escitalopram. Her neutrophil count rose to 2700x10(3)/mm3 2 days later, and was maintained at 2,900x10(3)/mm3 at 17 days after changing medication. To the best of our knowledge, this case represents the first report of ziprasidone - induced neutropenia in Korea. Further study is necessary to determine the incidence of neutropenia and its relationship with agranulocytosis secondary to ziprasidone.
Subject(s)
Adult , Female , Humans , Agranulocytosis , Antipsychotic Agents , Citalopram , Incidence , Korea , Neutropenia , Neutrophils , Quetiapine FumarateABSTRACT
Hiccups are due to involuntary contraction of the diaphragm and intercostals muscles. Most hiccups are self-limiting, but sometimes intractable hiccups can lead to multiple problems including exhaustion. Persistent or intractable hiccups may be related to the presence of serious underlying system disease. A 52-year-old male who had suffered from gastric cancer was consulted from surgical department due to persistent hiccups. Initially, he was unsuccessfully managed using conservative method, i.e., breath holding, induced gag reflex, and the oral administration of chlorpromazine. We administered risperidone quicklet, and then the hiccups disappeared. We conclude that risperidone quicklet is one of the useful treatment methods for persistent hiccups.
Subject(s)
Humans , Male , Middle Aged , Administration, Oral , Breath Holding , Chlorpromazine , Diaphragm , Hiccup , Muscles , Reflex , Risperidone , Stomach NeoplasmsABSTRACT
OBJECTIVE: Clozapine is known as an atypical antipsychotic drug which has less side effects in the extrapyramidal system than typical antipsychotic drugs and recommended as a treatment of choice in severe tardive dyskinesia (TD). However, it has been reported that the existing TD was worsened or new TD appeared in some cases where the antipsychotic drugs were switched to clozapine. METHODS: We experienced a single case in which TD was appeared in the tongue and jaw 5 months after chlorpromazine was switched to clozapine. RESULTS: The subject was 57 years old male patient with bipolar disorder. He had been treated intermittently with lithium and chlorpromazine for over 30 years. Five months after switching from chlorpromazine to clozapine, TD appeared in the tongue and jaw. Using Extrapyramidal Symptom Rating Scale (ESRS), the dyskinesia score was 10. Hence, clozapine was stopped and chlorpromazine was re-administrated resulting gradual improvement of TD. The dyskinesia score of ESRS was dropped to 6. CONCLUSION: It is speculated that this case is most likely a withdrawal tardive dyskinesia but other possibilities should be considered too. The question "Does withdrawal tardive dyskinesia occur more easily when switched to clozapine which has a weak dopamine antagonism?" should be addressed in future study.