Clozapine-related agranulocytosis
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Is clozapine-related agranulocytosis the result of the medication itself or due to an as yet unconfirmed report of a contaminant in the medication which has now been removed by the drug's manufacturers? To determine the answer to this question, the proposed research will compare incidence of precipitant agranulocytosis in a sample of 50 patients beginning clozapine treatment (all with a past history of clozapine-related agranulocytosis which is now cured). To place the proposed research in the context of the existing work in the field, this section of the proposal presents a comprehensive review of the literature. The first section of the review presents a general discussion of clozapine-induced agranulocytosis with an emphasis upon defining terms and providing basic facts about the condition. The second section of the presented review describes and discusses studies supporting the notion that the medication itself produces agranulocytosis while the third section presents a brief review of studies suggesting factors responsible for clozapine-induced agranulocytosis. The final section of the review provides at least preliminary data supporting the speculation that the development of agranulocytosis may not be clozapine-related, but may be actually due to a contaminant in the drug which the manufacture has presumably now removed. Among the psychotropic drugs, neuroleptics such as chlorpromazine or
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onses to various other neuroleptics.
Treatment with clozapine was followed up for 36 months following the initial administration of clozapine.
It was reported that at the time clozapine treatment was initiated, the mean duration of the illness had been between ten and 27 years.
Evaluative data were collected using various scales: total BPRS, BPRS "positive symptoms", BPRS "negative symptoms", PANSS positive and PANSS negative. Measures were collected at days 0 and 15, and at the end of the first three months, and then again every 3 months.
Significative improvements in total BPRS, BPRS positive symptoms and PANSS positive were reported at day 15. It was also found that clozapine produced significant improvement on the BPRS negative symptoms and the PANSS negative at one month.
In addition to the foregoing, Jalenques and Coudert (1994) also examined were for side effects. It was noted that about 15 percent of subjects experienced dry mouth during the first month of treatment. There were two cases of eosinophilia.
Some patients experienced an increase in total white blood cell count and about 32 percent of the subjects experienced weight gain. However, no agranulocytosis was found in this sample.
Another study in which
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Some common words found in the essay are:
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Approximate Word count = 9126
Approximate Pages = 37 (250 words per page)
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