Comment on "Lithium and Clozapine Rechallenge: A Retrospective Case Analysis."

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Sir: We refer to the interesting article from Drs. Kanaan and Kerwin¹ concerning the adjunctive use of lithium to treat clozapine-induced neutropenia.

Immediate discontinuation of clozapine treatment has always been the first therapeutic step in cases of severe to moderate neutropenia and impending agranulocytosis. However, some physicians are reluctant to terminate or even to interrupt clozapine treatment in patients with neutropenia, as the drug is often a last resort for those with complex symptomatologies.’ ‹