J Korean Med Sci.  2020 Jul;35(28):e226. 10.3346/jkms.2020.35.e226.

Incidence of Neutropenia with Valproate, Antipsychotics, and ADHD Medication Combination Treatment in Children and Adolescents

• Oh Y
• Joung YS
• Choi J

• KMID: 2504362
• DOI: http://doi.org/10.3346/jkms.2020.35.e226

Abstract

This study's aim was to investigate whether the incidence of neutropenia was higher in subjects who received a combination pharmacotherapy with valproate (VPA), antipsychotics (APs), and attention deficit hyperactivity disorder (ADHD) medication than in those administered only VPA and APs combination pharmacotherapy. We conducted this study through retrospective review of medical records. We collected the records of 231 children admitted to the National Center for Mental Health. The incidence of neutropenia was significantly higher in the VPA–APs–ADHD combination group than in the other groups (55.2% vs. 25% vs. 12%, VPA + AP + ADHD vs. VPA + AP vs. AP). The presence of the combination of VPA, APs, and ADHD medication was a powerful predictor of neutropenia occurrence after adjusting for age, gender, and body mass index (odds ratio, 6.43; 95% confidence interval, 2.26–18.26; P < 0.001) The combination of VPA, APs, and ADHD medication in children with psychiatric disease appears to increase the incidence of drug-induced neutropenia.

Keyword

Neutropenia; Child; Psychiatry; Valproate; Antipsychotics; Methylphenidate; Atomoxetine