{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T11:49:23Z","timestamp":1782388163382,"version":"3.54.5"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neuropsychopharm Rep"],"published-print":{"date-parts":[[2026,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n Clozapine is often unavailable to patients with treatment\u2010resistant schizophrenia when white blood cell (WBC) and neutrophil counts do not meet the required thresholds. This study aimed to examine changes in WBC and neutrophil counts and the factors associated with these changes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Thirty\u2010five patients with schizophrenia who received adenine, Ninjin\u2010yoei\u2010to, or lithium carbonate were included in the treatment group. Eighty\u2010one patients with schizophrenia comprised the control group. A two\u2010way mixed analysis of variance (ANOVA) was used to compare changes in WBC and neutrophil counts before and after treatment. Stepwise multiple regression analyses were conducted to identify factors associated with changes in WBC and neutrophil counts.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In the two\u2010way mixed ANOVA, WBC and neutrophil counts in the treatment group were significantly lower than those in the control group at baseline (\n p<\/jats:italic>\n \u2009<\u20090.001), and the counts at the final examination were significantly higher than the baseline values in the treatment group (\n p<\/jats:italic>\n \u2009<\u20090.001). Stepwise multiple regression analyses revealed that adenine and lithium carbonate were significant predictors of changes in WBC (adjusted R\n 2<\/jats:sup>\n \u2009=\u20090.173,\n p<\/jats:italic>\n \u2009<\u20090.001) and neutrophil counts (adjusted R\n 2<\/jats:sup>\n \u2009=\u20090.175,\n p<\/jats:italic>\n \u2009<\u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Lithium carbonate and adenine may help increase the WBC and neutrophil counts in patients with schizophrenia. These agents may be useful for patients with low WBC and neutrophil counts prior to initiating clozapine treatment.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/npr2.70144","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:34:42Z","timestamp":1781742882000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes in White Blood Cell and Neutrophil Counts in Patients With Schizophrenia Treated With Lithium Carbonate, Adenine, and Ninjin\u2010Yoei\u2010To: A Preliminary Study"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7683-7825","authenticated-orcid":false,"given":"Teruyuki","family":"Matsuoka","sequence":"first","affiliation":[{"name":"Department of Psychiatry NHO Maizuru Medical Center Kyoto Japan"},{"name":"Department of Psychiatry Kyoto Prefectural University of Medicine Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumihiro","family":"Yamano","sequence":"additional","affiliation":[{"name":"Department of Psychiatry NHO Maizuru Medical Center Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0000000000000904"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hup.917"},{"issue":"2","key":"e_1_2_13_4_1","first-page":"216","article-title":"Metabolic Syndrome, Total and Differential White Blood Cell Counts in Patients With Schizophrenia","volume":"28","author":"Pavlovic M.","year":"2016","journal-title":"Psychiatria Danubina"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.728990"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/2045125315624063"},{"issue":"1","key":"e_1_2_13_7_1","first-page":"72","article-title":"Management of Leukocytopenia due to Clozapine in a Case of Schizophrenia Using Lithium Carbonate, Adenine, and Alkaloids From Stephaura cepharantha Hayata Extracts","volume":"33","author":"Tezuka M.","year":"2021","journal-title":"Jpn Journal of Generic Hospital Psychiatry"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.9758\/cpn.2015.13.2.157"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40780-021-00227-6"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pcn5.70167"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2023.03.032"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/npr2.12497"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/pcn.12275"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1192\/pb.29.5.186"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0004867417720516"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0004867419833166"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajp.2021.102952"}],"container-title":["Neuropsychopharmacology Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/npr2.70144","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/npr2.70144","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/npr2.70144","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T11:22:47Z","timestamp":1782386567000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/npr2.70144"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/npr2.70144"],"URL":"https:\/\/doi.org\/10.1002\/npr2.70144","archive":["Portico"],"relation":{},"ISSN":["2574-173X","2574-173X"],"issn-type":[{"value":"2574-173X","type":"print"},{"value":"2574-173X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2026-02-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70144"}}