{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:46:42Z","timestamp":1791812802928,"version":"4.3.4"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 3","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Olanzapine is a frequently used second-generation antipsychotic, often considered to have a favorable hematological safety profile than clozapine. We report a rare case of recurrent pancytopenia associated with olanzapine rechallenge in a 46-year-old woman with acute psychotic episode. She had previously responded well to olanzapine but developed moderate hematological decline, which resolved on discontinuation. During current psychotic episode, olanzapine was re-initiated, and serial blood counts suggested progressive pancytopenia, which was confirmed on peripheral smear. Alternative causes including nutritional deficiencies and autoimmune disorders were ruled out. Olanzapine was discontinued and replaced with aripiprazole, following which all three cell lines normalized subsequently. This case demonstrates a clear temporal challenge\u2013dechallenge\u2013rechallenge association, confirming olanzapine as the causative agent. Clinicians should maintain a high degree of suspicion for hematological adverse effects even with olanzapine, especially in patients with prior cytopenic episodes. In such patients, baseline and serial hematological monitoring is advised and rechallenge is contraindicated.<\/jats:p>","DOI":"10.4103\/aam.aam_393_26","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T02:00:10Z","timestamp":1783908010000},"page":"S641-S644","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Recurrent Pancytopenia Associated with Olanzapine Rechallenge: A Rare Case Report with Literature Review"],"prefix":"10.4103","volume":"25","author":[{"given":"Saumya","family":"Mishra","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Jawaharlal Nehru Medical College, KAHER University, Belagavi, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bheemsain V.","family":"Tekkalaki","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Jawaharlal Nehru Medical College, KAHER University, Belagavi, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"R1-20261012","first-page":"e74677","article-title":"Olanzapine-induced thrombocytopenia in a patient with chronic schizophrenia: A case report","volume":"16","author":"Bokhari","year":"2024","journal-title":"Cureus"},{"key":"R2-20261012","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1159\/000052093","article-title":"One further case of pancytopenia induced by olanzapine in a Parkinson's disease patient","volume":"45","author":"Onofrj","year":"2001","journal-title":"Eur Neurol"},{"key":"R3-20261012","doi-asserted-by":"crossref","first-page":"2477","DOI":"10.1007\/s00277-020-04215-y","article-title":"Clozapine-induced agranulocytosis","volume":"99","author":"Mijovic","year":"2020","journal-title":"Ann Hematol"},{"key":"R4-20261012","doi-asserted-by":"crossref","first-page":"S377","DOI":"10.4103\/mjdrdypu.mjdrdypu_13_24","article-title":"Olanzapineinduced pancytopenia: Case report","volume":"17","author":"Prajnashree","year":"2024","journal-title":"Med J D Y Patil Vidyapeeth"},{"key":"R5-20261012","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1016\/j.pnpbp.2008.03.001","article-title":"Successful re-exposure to clozapine following uneventful rechallenge with olanzapine in a patient with neutropenia related to both agents","volume":"32","author":"Wu","year":"2008","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"key":"R7-20261012","first-page":"35","article-title":"Olanzapine-induced pancytopenia: A rare but worrying complication","volume":"27","author":"Pang","year":"2017","journal-title":"East Asian Arch Psychiatry"},{"key":"R8-20261012","first-page":"18","article-title":"A case of neutropenia and thrombocytopenia shortly after initiaing olanzapine","volume":"2","author":"Mehta","year":"2005","journal-title":"Psychiatry (Edgmont)"},{"key":"R9-20261012","doi-asserted-by":"crossref","first-page":"e000013","DOI":"10.1136\/gpsych-2018-000013","article-title":"Olanzapine-induced leucopaenia and thrombocytopaenia in an elderly patient: A case report and review of the evidence","volume":"31","author":"Malik","year":"2018","journal-title":"Gen Psychiatr"}],"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_393_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:01:41Z","timestamp":1791810101000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_393_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,10]]},"references-count":8,"journal-issue":{"issue":"Suppl 3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/aam.aam_393_26","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,10]]},"assertion":[{"value":"2026-04-06","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-08","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}