Mask Off? Lithium Augmentation for Clozapine Rechallenge After Neutropenia or Agranulocytosis

Article Abstract Because this piece does not have an abstract, we have provided for your benefit the first 3 sentences of the full text. To the Editor: Neutropenia (defined as an absolute neutrophil count < 1,500 cells/mm3) occurs in 3%-5% of individuals taking clozapine, and agranulocytosis (defined as an ANC < 500 cells/mm3) occurs in 0.38%-0.81%. To mitigate the risk of recurrent dyscrasia, lithium and granulocyte colony-stimulating factor may be added when clozapine is restarted. In a systematic review, Manu et al reported that 94% (33/35) of successful clozapine rechallenges included lithium augmentation.