Reactions 455 - 12 Jun 1993

★ SClomipramine

First report of concurrent agranulocytosis andhepatitis in an elderly patient: case report

A 67-year-old man with depression developed severeagranulocytosis and hepatitis following treatment withclomipramine 175 mg/day. One month after startingclomipramine, tests revealed anaemia, leucopenia and grosslyelevated hepatic transaminase levels. Three days afterwithdrawal of clomipramine and piroxicam, which he hadbeen taking for 18 months to treat osteoarthritis, a bonemarrow examination showed profound granulocytichypoplasia consistent with drug-induced neutropenia. At thisstage, his WBC was 1 x 10 sup(9)/L with 1.36% neutrophils.The biochemical and blood disturbances normalised over thefollowing 2-week period when his WBC rose to 4.6 x 10sup(9)/L with 53% neutrophils Author comment: ‘Of interest inthis case report is the concurrent appearance of seriousagranulocytopenia and elevation of hepatic transaminases,which has not previously been reported with clomipramine orother TCAs (tricyclic antidepressants).’Alderman CP, et al. Concurrent agranulocytosis and hepatitis secondary toclomipramine therapy. British Journal of Psychiatry 162: 688-689, May 1993 -Australia 800199404

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Reactions 12 Jun 1993 No. 4550114-9954/10/0455-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved