ArticleCureus2026
Sustained Hematological Stability During Clozapine Rechallenge With Adjunctive Lithium: A Case Report of 15-Month Follow-Up.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Clozapine is the most effective treatment for treatment-resistant schizophrenia, offering significant therapeutic benefits for patients who have failed to respond to other antipsychotic regimens. However, its clinical use is limited by the risk of severe hematological adverse events, particularly neutropenia and agranulocytosis. Lithium has been reported to induce leukocytosis through the stimulation of granulopoiesis and has been considered as a potential adjunctive strategy in the management of clozapine-associated neutropenia. However, long-term hematological outcomes of combined clozapine-lithium therapy remain insufficiently documented, particularly at subtherapeutic lithium levels. We report the case of a 32-year-old man with treatment-resistant schizophrenia and a prior history of clozapine-induced neutropenia. Following multiple antipsychotic treatment failures, clozapine was reintroduced and combined with low-dose adjunctive lithium (400 mg/day). Hematological and biochemical monitoring was conducted over a 15-month period, during which 25 sequential complete blood counts were analyzed. The mean leukocyte count was 9.23 ± 1.68 × 10³/mm³ (range: 5.55-13.07 × 10³/mm³), and the mean neutrophil count was 5.81 ± 1.49 × 10³/mm³ (range: 2.53-8.86 × 10³/mm³). No episodes of neutropenia were observed during follow-up. A strong positive correlation was found between total leukocyte and absolute neutrophil counts (r = 0.97; p < 0.001). Linear regression analysis showed no significant temporal decline in leukocyte levels (p = 0.846). Lithium plasma levels remained between 0.17 and 0.54 mmol/L, below the standard therapeutic range for mood stabilization. The patient showed clinical improvement and maintained global functioning without further psychiatric hospitalizations. This case suggests a possible role of adjunctive lithium in supporting hematological stability during clozapine therapy. Subtherapeutic lithium levels may be associated with stable leukocyte and neutrophil counts in selected cases; however, no causal relationship can be established. This approach should be considered exploratory and requires strict hematological monitoring.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.