system
What causes low WBC count during schizophrenia?
human
Hi.  My daughter is on clozaril for schizophrenia.  Only med that works for her after ten tears.  Last three months WBC went from 9 to 7.7 to 6.3.  Still within normal range so for now she can continue with this med but I feel somewhat concerned about  the declining numbers.  Is this a pattern that precedes a crucial drop in WBC and what is the normal fluctuating WBC from month to month in non consumers of clozaril?  As you might guess it is crucial that she be able to continue on this med.  if not I have read that there are things we might consider to stimulate production of blood cells.  I have differentials if required.  I know the future is uncertain but anything you can tell me about cause of fluctuations, viruses, nutrition etc. much appreciated.   Concerned mom.
gpt
Hello,I can understand your concern very well. The only major problem with clozaril is neutropenia which can develop at any time during treatment. One point is that when the neurtophil count goes down below normal level -we stop the drug. Second is - if there is a constant fall in WBC or neurtophil numbers for three consecutive readings, again it is advisable to stop this drug even if the counts are within range ( this fact is not much known, so often missed).To prevent the blood count falls- we recomemend Iron and folic acid and zinc tablets when we start clozapine.Along with them it is advisable to - eat more green leafy vegetables and fruits like pomegranate, amla ( indian gooseberries) and other fruits which have propensity to make blood.Its not proven scientifically, but in a condition called dengue- in India, several peopel are usually affected ( in this disease the also the blood counts fall significantly and become fatal some times)- a natural method which is parcticed successfully (along with normal medical methods)- juice of papaya plant leaves is given to the patients twice or thice  a day for few days-  (and the blood counts rise).so, if need arise you may try it if you feel.Rest is - monitor blood count closely; also keep a.check that she dosent develop fever or body aches.Start iron folic acid and zinc supplements. I hope your daughter keeps well on this medicine.Wish you luck.Dr. Manisha GopalMD Neuropsychiatry