Get access

Quetiapine XR-induced neutropenia: is a clozapine trial still possible for treatment-resistant schizophrenia? A case report


  • The content of this paper has not been published or submitted for publication elsewhere. All authors have contributed significantly to this paper and are in agreement with its content. The authors have received no financial support related to this paper and have no relationships that may lead to a conflict of interest.



Our case report addresses the use of clozapine in patients who have a history of quetiapine XR-induced neutropenia. There are no current guidelines for this situation.


We present the case of a young woman treated with clozapine at a first-episode psychosis clinic after a moderate quetiapine XR-induced neutropenia (0,5–1,0 × 109 L−1).


The patient was successfully treated with clozapine and lithium, with less psychotic symptoms and a better level of functioning. The neutrophil count remained normal during the treatment period, which has been longer than a year.


The outcome of this case supports the notion that clinicians could consider introducing clozapine in treatment-refractory patients who have a history of quetiapine XR-induced neutropenia, with close blood monitoring. Lithium co-administration may play a role in maintaining a normal neutrophil count.