Aplastic anemia is most commonly reported with chlorpromazine and trifluoperazine.

Aplastic anemia is most commonly reported with chlorpromazine and trifluoperazine.

• A. Leukopenia is more common than aplastic anemia
• B. Aplastic anemia is unrelated to chlorpromazine
• C. Aplastic anemia is only associated with SGAs
• D. Aplastic anemia is most commonly reported with chlorpromazine and trifluoperazine

Answer: (D)

Aplastic anemia is a rare but serious form of bone marrow failure where the marrow stops producing enough red cells, white cells, and platelets. Among antipsychotics, this severe hematologic toxicity has historical associations most strongly with the older phenothiazines, chlorpromazine and trifluoperazine, even though the overall risk is very small. The idea behind the statement is that case reports and safety data have linked these two drugs to aplastic anemia more often than others, which is why they’re singled out as the most commonly reported agents for this specific adverse effect. This concept is distinct from leukopenia, which is a lower white blood cell count but not the full pancytopenia seen in aplastic anemia, and from clozapine’s well-known risk of agranulocytosis, a different hematologic disorder. It’s also important to note that aplastic anemia has been reported with some older, first-generation antipsychotics and is not limited to second-generation drugs, so the association is not exclusive to newer agents.

Aplastic anemia is a rare but serious form of bone marrow failure where the marrow stops producing enough red cells, white cells, and platelets. Among antipsychotics, this severe hematologic toxicity has historical associations most strongly with the older phenothiazines, chlorpromazine and trifluoperazine, even though the overall risk is very small. The idea behind the statement is that case reports and safety data have linked these two drugs to aplastic anemia more often than others, which is why they’re singled out as the most commonly reported agents for this specific adverse effect. This concept is distinct from leukopenia, which is a lower white blood cell count but not the full pancytopenia seen in aplastic anemia, and from clozapine’s well-known risk of agranulocytosis, a different hematologic disorder. It’s also important to note that aplastic anemia has been reported with some older, first-generation antipsychotics and is not limited to second-generation drugs, so the association is not exclusive to newer agents.