Which antipsychotic is associated with pancytopenia?

Which antipsychotic is associated with pancytopenia?

• A. Quetiapine
• B. Clozapine
• C. Olanzapine
• D. Risperidone

Answer: (A)

Pancytopenia means a drop in all three blood cell lines—red cells, white cells, and platelets—which can lead to anemia, infections, or bleeding. Among antipsychotics, the drug most strongly linked to this serious bone marrow suppression is clozapine. It carries a well-known risk of agranulocytosis (a dangerous drop in neutrophils) and can rarely cause broader cytopenias, so people on clozapine require regular, ongoing blood monitoring from the start of treatment. The other antipsychotics listed do not have pancytopenia as a defining or expected risk. They can have metabolic, sedation, or extrapyramidal side effects, but, in contrast to clozapine, they are not singled out for causing significant bone marrow suppression in routine practice.

Pancytopenia means a drop in all three blood cell lines—red cells, white cells, and platelets—which can lead to anemia, infections, or bleeding. Among antipsychotics, the drug most strongly linked to this serious bone marrow suppression is clozapine. It carries a well-known risk of agranulocytosis (a dangerous drop in neutrophils) and can rarely cause broader cytopenias, so people on clozapine require regular, ongoing blood monitoring from the start of treatment.

The other antipsychotics listed do not have pancytopenia as a defining or expected risk. They can have metabolic, sedation, or extrapyramidal side effects, but, in contrast to clozapine, they are not singled out for causing significant bone marrow suppression in routine practice.