Abstract
Objective
To investigate whether the incidence of neutropenia was higher in subjects who received
a combination treatment with valproate and quetiapine than in those who were administered
monotherapy.
Design
Retrospective cohort study.
Setting
Rehabilitation department of a university hospital.
Participants
Patients with acquired brain injuries who had taken valproate for seizures or quetiapine
for delirium for >7 days (N=101). Data were extracted from electronic medical records
of the hospital.
Interventions
Not applicable.
Main Outcome Measures
Incidence of neutropenia (absolute neutrophil count<2000 cells/μL) was elicited from
the weekly complete blood cell records for 71.07±43.71 days of observation. The odds
ratio for neutropenia development was calculated and adjusted for variables that showed
significant differences between patients with or without neutropenia.
Results
The incidence of neutropenia was significantly higher in the group receiving the combination
treatment than in those receiving the monotherapy (32.26% vs 12.90%, adjusted P=.036), despite a lack of any differences in the daily doses of the medications. Coadministration
of quetiapine and valproate was the predictor of neutropenia development when age,
body weight, and underlying diseases were adjusted in the logistic regression model
(odds ratio=3.749; 95% confidence interval, 1.161–12.099; P=.027).
Conclusions
Administration of quetiapine together with valproate in patients with acquired brain
injury could increase the incidence of medication-induced neutropenia.
Keywords
List of abbreviations:
ANC (absolute neutrophil count), CTC (Common Toxicity Criteria), HS (hemorrhagic stroke), IS (ischemic stroke), TBI (traumatic brain injury)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: September 28, 2015
Footnotes
Supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education, Science and Technology (grant no. 2014R1A1A2055505).
Disclosures: none.
Identification
Copyright
© 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
