A case report: Clozapine-induced leukopenia and neutropenia after mRNA COVID-19 vaccination

Neuropsychopharmacol Rep. 2022 Jun;42(2):238-240. doi: 10.1002/npr2.12238. Epub 2022 Feb 15.

Abstract

Clozapine is an atypical antipsychotic used for treatment-resistant schizophrenia and is known to cause serious side effects, such as leukopenia and neutropenia. We encountered the case of a 44-year-old female patient with a good response to clozapine, who experienced inflammatory reaction and cytopenia after coronavirus disease 2019 (COVID-19) vaccination. Soon after clozapine discontinuation, the inflammatory reaction resolved, and cell counts recovered. There are only a few reports on the interaction between clozapine and COVID-19 vaccine. Our findings suggest that caution is required when a patient who is receiving clozapine scheduled for COVID-19 vaccination, owing to the possibility of cytopenia. Moreover, blood tests and the measurement of clozapine concentration should be performed before and after the inoculation to ensure patient safety.

Keywords: COVID-19 vaccine; clozapine; leukopenia; neutropenia; schizophrenia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • COVID-19 Drug Treatment*
  • COVID-19 Vaccines / adverse effects
  • COVID-19* / prevention & control
  • Clozapine* / adverse effects
  • Female
  • Humans
  • Neutropenia* / chemically induced
  • RNA, Messenger
  • Schizophrenia* / drug therapy
  • Vaccination

Substances

  • COVID-19 Vaccines
  • RNA, Messenger
  • Clozapine