A case of improvement of clozapine-induced low leukocyte counts by adenine, cepharanthin and ninjin-yoei-to in a patient with treatment-resistant schizophrenia

Abstract Background Although clozapine is the optimal drug for patients with treatment-resistant schizophrenia, the drug has harmful adverse effects such as leukopenia. Adenine and cepharanthine are known to be effective for radiation- or drug-induced leukopenia. Furthermore, ninjin-yoei-to, a Chine...

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Autores principales:	Shintaro Kamei, Ryota Tanaka, Hirofumi Hirakawa, Motoshi Iwao, Rikako Kawanaka, Ryosuke Tatsuta, Takeshi Terao, Hiroki Itoh
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Treatment-resistant schizophrenia Clozapine Leukopenia Ninjin-yoei-to Therapeutics. Pharmacology RM1-950 Pharmacy and materia medica RS1-441
Acceso en línea:	https://doaj.org/article/56cbba50404e4234bb5f13a27b4c2b41
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spelling	oai:doaj.org-article:56cbba50404e4234bb5f13a27b4c2b412021-12-05T12:03:14ZA case of improvement of clozapine-induced low leukocyte counts by adenine, cepharanthin and ninjin-yoei-to in a patient with treatment-resistant schizophrenia10.1186/s40780-021-00227-62055-0294https://doaj.org/article/56cbba50404e4234bb5f13a27b4c2b412021-12-01T00:00:00Zhttps://doi.org/10.1186/s40780-021-00227-6https://doaj.org/toc/2055-0294Abstract Background Although clozapine is the optimal drug for patients with treatment-resistant schizophrenia, the drug has harmful adverse effects such as leukopenia. Adenine and cepharanthine are known to be effective for radiation- or drug-induced leukopenia. Furthermore, ninjin-yoei-to, a Chinese herbal medicine, augments the production of granulocyte-macrophage colony-stimulating factor. Thus, these drugs may be useful for clozapine-induced leukopenia. Case presentation A 21 years-old woman with schizophrenia was hospitalized for initiation of clozapine treatment. Despite concomitant use of adenine, cepharanthine, and lithium carbonate having activities of increasing leukocytes, a decrease in leukocyte counts occurred after the initiation of clozapine. Additional administration of ninjin-yoei-to increased leukocyte counts, which prevented the development of leukopenia. Conclusions This is the first case that concomitant use of adenine, cepharanthin, and ninjin-yoei-to exhibited the effectiveness of reversing the decrease in leukocytes caused by clozapine. Monitoring leukocyte counts and preventing leukopenia are essential for successful treatment with clozapine for refractory schizophrenia. These medicines may be a potential option for preventing clozapine-induced leukopenia.Shintaro KameiRyota TanakaHirofumi HirakawaMotoshi IwaoRikako KawanakaRyosuke TatsutaTakeshi TeraoHiroki ItohBMCarticleTreatment-resistant schizophreniaClozapineLeukopeniaNinjin-yoei-toTherapeutics. PharmacologyRM1-950Pharmacy and materia medicaRS1-441ENJournal of Pharmaceutical Health Care and Sciences, Vol 7, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Treatment-resistant schizophrenia Clozapine Leukopenia Ninjin-yoei-to Therapeutics. Pharmacology RM1-950 Pharmacy and materia medica RS1-441
spellingShingle	Treatment-resistant schizophrenia Clozapine Leukopenia Ninjin-yoei-to Therapeutics. Pharmacology RM1-950 Pharmacy and materia medica RS1-441 Shintaro Kamei Ryota Tanaka Hirofumi Hirakawa Motoshi Iwao Rikako Kawanaka Ryosuke Tatsuta Takeshi Terao Hiroki Itoh A case of improvement of clozapine-induced low leukocyte counts by adenine, cepharanthin and ninjin-yoei-to in a patient with treatment-resistant schizophrenia
description	Abstract Background Although clozapine is the optimal drug for patients with treatment-resistant schizophrenia, the drug has harmful adverse effects such as leukopenia. Adenine and cepharanthine are known to be effective for radiation- or drug-induced leukopenia. Furthermore, ninjin-yoei-to, a Chinese herbal medicine, augments the production of granulocyte-macrophage colony-stimulating factor. Thus, these drugs may be useful for clozapine-induced leukopenia. Case presentation A 21 years-old woman with schizophrenia was hospitalized for initiation of clozapine treatment. Despite concomitant use of adenine, cepharanthine, and lithium carbonate having activities of increasing leukocytes, a decrease in leukocyte counts occurred after the initiation of clozapine. Additional administration of ninjin-yoei-to increased leukocyte counts, which prevented the development of leukopenia. Conclusions This is the first case that concomitant use of adenine, cepharanthin, and ninjin-yoei-to exhibited the effectiveness of reversing the decrease in leukocytes caused by clozapine. Monitoring leukocyte counts and preventing leukopenia are essential for successful treatment with clozapine for refractory schizophrenia. These medicines may be a potential option for preventing clozapine-induced leukopenia.
format	article
author	Shintaro Kamei Ryota Tanaka Hirofumi Hirakawa Motoshi Iwao Rikako Kawanaka Ryosuke Tatsuta Takeshi Terao Hiroki Itoh
author_facet	Shintaro Kamei Ryota Tanaka Hirofumi Hirakawa Motoshi Iwao Rikako Kawanaka Ryosuke Tatsuta Takeshi Terao Hiroki Itoh
author_sort	Shintaro Kamei
title	A case of improvement of clozapine-induced low leukocyte counts by adenine, cepharanthin and ninjin-yoei-to in a patient with treatment-resistant schizophrenia
title_short	A case of improvement of clozapine-induced low leukocyte counts by adenine, cepharanthin and ninjin-yoei-to in a patient with treatment-resistant schizophrenia
title_full	A case of improvement of clozapine-induced low leukocyte counts by adenine, cepharanthin and ninjin-yoei-to in a patient with treatment-resistant schizophrenia
title_fullStr	A case of improvement of clozapine-induced low leukocyte counts by adenine, cepharanthin and ninjin-yoei-to in a patient with treatment-resistant schizophrenia
title_full_unstemmed	A case of improvement of clozapine-induced low leukocyte counts by adenine, cepharanthin and ninjin-yoei-to in a patient with treatment-resistant schizophrenia
title_sort	case of improvement of clozapine-induced low leukocyte counts by adenine, cepharanthin and ninjin-yoei-to in a patient with treatment-resistant schizophrenia
publisher	BMC
publishDate	2021
url	https://doaj.org/article/56cbba50404e4234bb5f13a27b4c2b41
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A case of improvement of clozapine-induced low leukocyte counts by adenine, cepharanthin and ninjin-yoei-to in a patient with treatment-resistant schizophrenia

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