Family and Caregiver Schizophrenia Discussion Forum

Starting Clozapine with really low ANC?!

My son is in the hospital and the doctor decided to put him on Clozapine again after he stopped taking it back in March
His ANC is 1.75 which is below the range or on the edge !
He started him with 25mgs morning and 25evening and giving him lithium along with it to increase the white blood cells!
After a week a blood test was done,and his ANC was 1.57 this time,and he decided to increase the Clozapine 50 morning and 50 evening :unamused:
Im so scared since this is a very low number and it could keep dropping and cause him infection and death
Doctor is so stubborn and get pissed when parents or family say their opinion
Opinions please

Is this Dr. someone you are stuck with due to uncontrollable circumstances? Is this the hospital psych. his personal psych?
It is difficult to get into see a new psychiatrist nowadays but you may want to start the process of finding one that will work better with you and your son. Personally, if any Dr. of mine or my family got "pissed " at me for something like this…(I’m assuming this means angry ) I would make a written complaint.
I’m sorry you have to go through this kind of worry and stress.

Thanks for your reply
Yes we’re stuck with him
My son is on an involuntary hospitalization (5250)and this doctor is the director of the hospital
Whenever we tell him something he makes sure he does the opposite (not only in this hospitalization,in other ones too)
He takes it personally and thinks that people are teaching him what to do…
And all other doctors in that hospital are under him snd they can’t do anything without asking him first…
He’s simply a dictator!

How long does Lithium take to increase WBCs?

I did find several publication that state Lithium can be used successfully to treat clozapine-induced neutropenia. But they dont say how long it takes to get the numbers up. You may want to ask him.
This is one of the articles.

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He’s been in lithium for over 3 years
Lithium stops working at certain point😞
He’s very sensitive to it too,but it was given to treat the Clozapine issues

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I read somewhere that lithium will stop raising the white blood cells ,so it just temporary
Thanks for the research you did…

The number they look at to increase testing, without stopping treatment, is an ANC of 1.49. At that point, neutropenia is considered mild and they increase testing to 3 times a week until the number returns to 1.5 or higher.

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Thanks for your reply
Do you know if the ANC is dosage related or not?

I don’t know. I do know that it can fluctuate.

How is he doing otherwise ?

He’s hallucinating a lot,like 24/7
Disoriented ,almost non verbal when we talk to him

He was on Clozapine before but he stopped because of the voices,they were telling him “stop it”
So now he’s back on it

Has he ever been postive symptom free with Clozapine?

He always hallucinated but it was less in the beginning of treatment
I noticed that It was getting worse the more it was increased

Talk to your doctor about using litthium also it increases the White blood count thats what they did with my grandson and he was fine . After a year he stopped taking it good luck.

It took my grandson a day or two. He stayed on lithium for about a year and quit on his own and has been fine for the last 4 years. He came out of the hospital on a lot of medications seroquel lihium clozapine, resperidal, depakote and artane. We got him off all but Clozapine 350mg. He works fulltime has friends and is enjoying his life. Voices are 95% gone. I call it a miracle

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That’s a lot :anguished:
Why so many antipsychotics at the same time?!
Im glad he was able to get off of most of them and stayed on one!
My son is taking lithium carbonate 450 mg extended release
The NC went up a little bit last Saturday so that’s good
Thanks for your reply

Who knows i got him off them as quick as I could. I he did much better. No more zombie

Thats great
The zombie part is what’s worrying me
Im not sure if the lithium is causing it or the high level serum Clozapine
Do you know what’s the serum level of Clozapine of your grandson?