Objective: Most of the reported Olanzapine induced leukocytopenia cases are generally associated with elderly or other metabolic diseases. We present a 23 years old female diagnosed as obsessive compulsive disorder (OCD) in whom neutropenia developed due to Olanzapine.
Case: The patient, who had diagnosis of OCD for three years and was treated with SSRIs previously, stopped drug intake few months ago. Symptoms of OCD exacerbated and additionally psychomotor agitation, irritability, rejection of treatment and persecutory thoughts started. She was hospitalized and Olanzapine 5 mg/d, Lorazepam 3mg/day were ordered. At the admission day the routine hematological and biochemical laboratory exams were in normal ranges. Olanzapine dosage was titrated up to 15mg/d in four days and psychotic features recovered on a large scale. Neutropenia was noticed at the sixth day of medication and Olanzapine was immediately stopped and Lorazepam was continued. No clinical signs of an infection occurred. After discontinuation of Olanzapine the blood cell counts started to increase at the first day and turned back to normal ranges at the sixth day. No special treatment was necessary. Psychiatric symptoms were remitted partially with Sertralin 200mg/g in 4 months.
Conclusion: Although the hematological effects of Olanzapine are still not clear exactly in this case the only probable agent to cause neutropenia is Olanzapine in young patient with no metabolic problems. Such a case would stress the importance of monitoring the patients while using antipsychotics whether they had a risk factor or not.