Evaluación y seguimiento hematológico del paciente con diagnóstico de esquizofrenia

Objectives To guide the clinician in taking decisions on the best strategies for assessing and monitoring the risk of blood disorders in adults diagnosed with schizophrenia in pharmacological treatment. Method A clinical practice guideline was developed following the guidelines of the Methodological Guide of the Ministry of Social Protection to collect evidence and grade recommendations. De novoliterature researchwas performed. Results With the use of antipsychotics there isriskofreducción in the leukocyte count and the risk of agranulocytosis,the later associated with the use of clozapine, although it is a rare event(0.8%) can be fatal; this effect occurs most frequently in the first twelve weeks of treatment and the risk is maintained aroundthe first year of it. Conclusion The recommendations were considered strongin all hematologic related monitoring.A blood count should be taken at the start of pharmacological treatment. If the patient is started on clozapine one shouldbe taken weekly during the first three months, monthly until completing one year and every six months thereafter. If there is a decrease in white blood cell count the patient should be monitored regularly, stopping if is a less than 3,500 cells/mm³ and consider referral if is less than 2,000 cells/mm³.