Pharmacopsychiatry 2024; 57(02): 78-81
DOI: 10.1055/a-2262-8297
Letter to the Editor

Risperidone-Induced Leukoneutropenia: Evidence from a Positive Rechallenge and Review of the Literature

1   Department of Pharmacovigilance, University of Sousse, Tunisia
Ahlem Ghanmi
2   Department of Psychiatry, Farhat Hachad Hospital, Sousse University, Tunisia
Soumaya Gazzeh
2   Department of Psychiatry, Farhat Hachad Hospital, Sousse University, Tunisia
Bochra Saguem
2   Department of Psychiatry, Farhat Hachad Hospital, Sousse University, Tunisia
Raoudha Slim
1   Department of Pharmacovigilance, University of Sousse, Tunisia
Jaafar Nakhli
2   Department of Psychiatry, Farhat Hachad Hospital, Sousse University, Tunisia
Chaker Ben Salem
1   Department of Pharmacovigilance, University of Sousse, Tunisia
› Author Affiliations

Antipsychotics can cause hematologic disorders, and they can have life-threatening consequences. Risperidone, less commonly associated with hematologic adverse effects, is an atypical antipsychotic medication used to treat conditions such as schizophrenia, bipolar disorder and irritability associated with autism. While risperidone primarily affects the central nervous system, it can have some hematologic adverse effects, although these are relatively rare. It is crucial to note that these side effects are not common, and most people taking risperidone do not experience hematologic disorders. The reporting of such disorders may be more frequent with clozapine compared to other atypical antipsychotics because clozapine treatment necessitates regular hematological monitoring [1].

Publication History

Received: 07 January 2024
Received: 01 February 2024

Accepted: 05 February 2024

Article published online:
12 March 2024

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

  • References

  • 1 Tiihonen J, Tanskanen A, Bell JS. et al. Long-term treatment with clozapine and other antipsychotic drugs and the risk of haematological malignancies in people with schizophrenia: a nationwide case-control and cohort study in Finland. Lancet Psychiatry 2022; 9: 353-362
  • 2 Naranjo CA, Busto U, Sellers EM. et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981; 30: 239-245
  • 3 Oyesanmi O, Kunkel EJ, Monti DA. et al. Hematologic side effects of psychotropics. Psychosomatics. 1999; 40: 414-421
  • 4 Stübner S, Grohmann R, Engel R. et al. Blood dyscrasias induced by psychotropic drugs. Pharmacopsychiatry 2004; 37: S70-S78
  • 5 Meylan C, Bondolfi G, Aubert AC. et al. Reversible neutropenia during a cold: possible involvement of risperidone? A case report. Eur Neuropsychopharmacol 1995; 5: 1-2
  • 6 Bondolfi G, Morena P, Dascal DR. et al. Risperidone and reversible neutropenia: a negative rechallenge. Eur Neuropsychopharmacol J 1996; 6: 257
  • 7 Dernovsek Z, Tavcar R. Risperidone-induced leucopenia and neutropenia. Br J Psychiatry 1997; 171: 393-394
  • 8 Etain B, Roubaud L, Le Heuzey MF. et al. A case of leukopenia in treatment with risperidone in an adolescent. L’Encephale 2000; 26: 81-84
  • 9 Sluys M, Güzelcan Y, Casteelen G. et al. Risperidone-induced leucopenia and neutropenia: a case report. Eur Psychiatry J Assoc Eur Psychiatr 2004; 19: 117
  • 10 López Altimiras FX, Muñoz Rodríguez FJ, Escoté Llobet S. Leukopenia associated to the use of risperidone: a case report and review of the literature. Rev Clin Esp 2006; 206: 162-163
  • 11 Uzun S, Kozumplik O, Jakovljević M. et al Leukopenia during therapy with risperidone long-acting injectable: two case reports. J Clin Psychopharmacol déc 2008; 28: 713-714
  • 12 Erbey F, Ruzgar H, Okur M. The risperidone-induced leukopenia and neutropenia: A case at 7 years old. Anadolu Psikiyatri Dergisi 2011; 12: 243-244
  • 13 Tseng CC. Neutropenia during risperidone treatment. J Neuropsychiatry Clin Neurosci 2011; 23: E19
  • 14 Manfredi G, Solfanelli A, Dimitri G. et al. Risperidone-induced leukopenia: a case report and brief review of literature. Gen Hosp Psychiatry 2013; 35: 102.e3-6
  • 15 Farrell H, Eastman P. Risperidone-induced neutropenia: an adverse side effect in the palliative management of delirium in a patient with lymphoma. BMJ Support Palliat Care 2013; 3: 4-5
  • 16 Raj V, Druitt T, Purushothaman S. et al. Risperidone/paliperidone induced neutropenia and lymphopenia. Aust N Z J Psychiatry 2013; 47: 291-292
  • 17 Hou YC, Lai CH. The relief of leukocytopenia within 1 month after switching risperidone to amisulpride. J Neuropsychiatry Clin Neurosci 2014; 26: E40-E41
  • 18 Kattalai Kailasam V, Chima V, Nnamdi U. et al. Risperidone-induced reversible neutropenia. Neuropsychiatr Dis Treat 2017; 13: 1975-1977
  • 19 Woon LSC, Tee CK, Gan LLY. et al. Olanzapine-induced and Risperidone-induced Leukopenia: A Case of Synergistic Adverse Reaction?. J Psychiatr Pract 2018; 24: 121-124
  • 20 McGuire PR, Coplan BM, Puri S. Successful Long-Acting Paliperidone Treatment Following Reversible Risperidone-Induced Neutropenia. Prim Care Companion CNS Disord 2020; 22: 19l02516
  • 21 Atolagbe A, Nkemjika S, Popoola O. et al. Risperidone-Induced Neutropenia in a Schizophrenic Patient: A Case Report and Literature Review. Case Rep Psychiatry 2021; 2021: 3980872
  • 22 Coşar B, Taner ME, Eser HY. et al. Does switching to another antipsychotic in patients with clozapine-associated granulocytopenia solve the problem? Case series of 18 patients. J ClinPsychopharmacol 2011; 31: 169-173
  • 23 Flanagan RJ, Dunk L. Haematological toxicity of drugs used in psychiatry. Human Psychopharmacology: Clinical and Experimental 2008; 23: S27-S41