A 50-year-old schizophrenic woman has been treated with sulpiride (Dogmatil) for 15 years./nShe now

Fråga: A 50-year-old schizophrenic woman has been treated with sulpiride (Dogmatil) for 15 years.

She now has a low white blood cell count (2.8 x 10(9)/L). Differential count, haemoglobin and thrombocytes are normal. She is at present taking no other medication. Two or three months ago she had several infections and was treated with a number of antibiotics, not specified.

Is leukopenia a known side-effect of sulpiride?

Sammanfattning: Leukopenia has only very rarely been reported as a side-effect of sulpiride, and this patient has been treated for many years, which makes sulpiride a less probable causative. In any case, we recommend regular follow-up of blood values until normalised.

Svar: Sulpiride is not available on the Swedish market, except by special license from the Medical Product Agency (MPA).

It is a substituted benzamide (as is remoxiprid), a less-sedative neuroleptic, and is also said to have anti-depressant effects in low doses (1).

We have found no references in Medline or pharmacological handbooks concerning sulpiride and haematological side-effects.

The adverse effect files of WHO contain two reports from 1978 and 1985 on sulpiride and leukopenia. The files also contain 6 reports on agranulocytosis and 4 on granulocytopenia.

In general, haematological side-effects are more likely to occur within two or three months of treatment, and in this case recent infections and/or antibiotics seem more likely to be the cause of leukopenia. 1 Dollery, Therapeutic drugs. 1991