{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T20:44:09Z","timestamp":1792701849487,"version":"4.5.0"},"reference-count":26,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Acta Neuropsychiatr."],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S0924270824000541_as1\">\n\t    <jats:title>Objectives:<\/jats:title>\n\t    <jats:p>Clozapine is an atypical antipsychotic crucial for treatment-resistant schizophrenia, characterised by its multi-receptor targeting, including serotonin (5-HT2A, 5-HT2C) and dopamine (D1, D2, D3, D4) receptors, among others. This broad mechanism is effective against positive symptoms of schizophrenia with a lower incidence of extrapyramidal side effects. However, clozapine poses significant haematological risks, notably agranulocytosis, necessitating stringent blood monitoring protocols.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0924270824000541_as2\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>This study examined haematological parameters in 157 patients on clozapine therapy, analysing the prevalence and clinical correlations of haematological abnormalities such as leucocytosis, thrombocytosis, and alterations in red blood cell distribution width (RDW) and mean platelet volume (MPV).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0924270824000541_as3\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>The findings revealed leucocytosis in 36.9% of patients, thrombocytosis in 8.9%, and elevated RDW in 23.6%. Notably, higher clozapine doses were associated with leucocytosis, though no significant correlations were found between clozapine dose, duration of use, and changes in RDW, mean corpuscular haemoglobin concentration, or MPV.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0924270824000541_as4\">\n\t    <jats:title>Conclusion:<\/jats:title>\n\t    <jats:p>The study\u2019s results underscore the necessity of regular haematological monitoring to mitigate the risks of clozapine therapy while leveraging its therapeutic benefits. Additionally, the study suggests personalised dosing strategies to balance efficacy and safety, particularly in managing clozapine-induced haematological changes.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/neu.2024.54","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T04:35:22Z","timestamp":1732163722000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["Significant haematological alterations in clozapine-treated patients: prevalence and clinical correlation"],"prefix":"10.1017","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7479-5622","authenticated-orcid":false,"given":"Muhammed Fatih","family":"Tabara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4534-0988","authenticated-orcid":false,"given":"Cafer Baris","family":"Akar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2016-2637","authenticated-orcid":false,"given":"Mehmet Kadir","family":"Atdagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8998-0743","authenticated-orcid":false,"given":"Mehmet Gurkan","family":"Gurok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2772-4124","authenticated-orcid":false,"given":"Murad","family":"Atmaca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"key":"S0924270824000541_ref19","first-page":"816","article-title":"Leukocytosis associated with clozapine treatment: a case series and systematic review of the literature","volume":"57","author":"Paribello","year":"2021","journal-title":"Medicina (Lithuania)"},{"key":"S0924270824000541_ref20","doi-asserted-by":"crossref","first-page":"116","DOI":"10.4103\/aip.aip_173_22","article-title":"Mean platelet volume, red cell distribution width, and platelet distribution width in patients of schizophrenia and bipolar disorder: a retrospective hospital-based study","volume":"8","author":"Sathe","year":"2024","journal-title":"Annals of Indian Psychiatry"},{"key":"S0924270824000541_ref16","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.schres.2014.04.038","article-title":"Mean platelet volume in schizophrenia unaltered after 1year of clozapine exposure","volume":"157","author":"Lee","year":"2014","journal-title":"Schizophrenia Research"},{"key":"S0924270824000541_ref22","doi-asserted-by":"publisher","DOI":"10.1017\/9781108975292"},{"key":"S0924270824000541_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2024.01.001"},{"key":"S0924270824000541_ref18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1742-2094-10-43","article-title":"Neuroinflammation and psychiatric illness","volume":"10","author":"Najjar","year":"2013","journal-title":"Journal of Neuroinflammation"},{"key":"S0924270824000541_ref3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2009.02298.x"},{"key":"S0924270824000541_ref15","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1097\/JCP.0b013e3181e6a082","article-title":"Clozapine is cytotoxic to primary cultures of human bone marrow mesenchymal stromal cells","volume":"30","author":"Lahdelma","year":"2010","journal-title":"Journal of Clinical Psychopharmacology"},{"key":"S0924270824000541_ref17","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1097\/JCP.0000000000001765","article-title":"Clozapine-associated agranulocytosis: a systematic review. 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Published by Cambridge University Press on behalf of Scandinavian College of Neuropsychopharmacology","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e41"}}