Low White Blood Cell Count - Anyone heard of Meds Causing This
My son who was diagnosed with BP at age 3, is now 8. We had a neuropsych eval completed in December, which changed his diagnosis to Childhood Disintegrative Disorder with Adjustment Disorder of Mixed Emotions and Mild Mental Retardation. We've pretty much kept his meds the same because of the severity of his moods and rages. He also has seizures and is on two different meds for that.
His current meds are: Seroquel 200 mg; Seroquel XR 200 mg; Abilify 10 mg; Lamictal 50 mg three times a day; Zonisimide started with 25 mg once a day and adding 25 mg every five days to get to 100 mg two times a day. He was taken off of Carbamazepine two weeks ago because when they drew labs for that it was too high.
Three weeks ago my son started running an extremely high fever. Took him to the doctor was told he had an ear infection and throat infection. He was put on antibiotics. Two days later still running fever in excess of 103. He started vomiting and I took him to ER. They sent us home with anti-nausea meds. Two days later took him to the doctor. He had not eaten since the day before his fever started, hardly drinking anything. She said take him home, try and get him to drink as much as we could and bring him back the next day. Took him back, tried IV fluids in the office after lab work. Labs came back with WBC count 2.3 and it shouldn't be lower than 5. So admitted him to the hospital for fluids and tests. Every test came back negative. Everyone is thinking that it's his meds.
Last week his WBC count had gone up to 3.3. Then yesterday he got sick again. Took him to have labs drawn this morning and back down to 2.3.
They consulted with a hematologist and he's also saying meds. He wants labs drawn for three weeks and then he will look at all the results and see where we go at that point.
I'm so frustrated and confused and not really sure what to think right now. If it is meds what do we do? He can't take Risperdal or Depakote. He's actually pretty stable right now! UGGGHHHH!!!!
Thank you for any insight.
Cassandra
Hi Cassandra,
A well known side effect to Tegretol (Carbamazepine) is a low white blood cell count. You can read more here. It wouldn't surprise me seeing this happen since his level got too high.
Hope your son is feeling better soon!
--
Jackie aka mom2one
Forums moderator, FRT
Mom to Mr. 17 (dx'd at age 4), Bipolar, Psychotic Disorder, Anxiety Disorder, PDD, Cognitive Disorder
Meds: Seroquel 900 mg., Risperdal 4.5 mg., Fanapt 12 mg., Lamictal 600 mg., Lithium 1250 mg., DDAVP, and Synthroid .150 mcg
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It's also possible for a viral infection to suppress the WBC's, so that's something to keep in mind. Of course the Tegretol seems like the most likely culprit in this case, and hopefully the hematologist considered the possibility of a viral cause.
I hope he starts feeling better soon.
--
Brenda,50, CABF Parent to Parent Volunteer
Mom to A, 16, BP, Tourette's, OCD, ADHD: Eskalith CR, Trilafon, Lamictal, Seroquel, Cytomel
E, 14, BP,AS, hypothyroidism: Seroquel, Eskalith CR, levothyroxin, inositol
B, 13 & H, 10
Married 17 years to DH, 49
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FROM CABF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.
This can also happen with Depakote - our daughter was tried on this in the hospital and her WBC dropped to 2.8. Had to switch to Lithium at age 7.
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Jen
Mom of Josh, 11, PDD, ADHD, GAD, FASD, taking Trileptal 1500, Strattera 80, Tenex 3
and Emerson (Emme), 8 BP1 with psychotic features, FASD, ADHD, ODD, taking Lithium 750, Focalin XR 15, Focalin 2.5 Tenex 2.5, melatonin 3
My younger daughter has had neutropenia for many many years. She does also seem to have a weaker immune system. We do not know why she has this and she has been off meds that could cause this for years. Was it triggered by earlier meds? We don't know. We are just used to the red results on the sheet, and they have not changed (better or worse) in years even though she seems to be healthier in general.
--"Naomi"
Older dd: teen-onset bipolar: Off meds and over withdrawal symptoms. After over 13 years - STABLE! Treated: Sleep, Candida, food sensitivities, nutritional needs, extra thyroid meds.
Younger dd: Childhood-onset schizoaffective, with disabling migraines since infancy. Also off antipsychotic and meds for migraines. Stable - no hallucinations. Treated for multiple endocrine problems, food sensitivities, nutritional/mitochondrial needs, gut issues, SLEEP issues.
My son, who is 8 has just started having labs come back with a low WBC. He has been on Trileptal, Seroquel, and Strattera for over a year and a half. Our Psychiatrist said he has stared hearing of cases where Seroquel is lowering the WBC, so he started testing it in his patients. After lowering the Seroquel nighttime dose from 300mg to 200mg, the WBC is still low. We are now in the process of lowing the Seroquel nighttime dose to 150mg and the Trileptal from 150 3Xday to 100 3Xday. He has just started getting to a point in school where he is progressing (he has a diagnosed learning disability - grade 3 but reading at grade 1), feeling confident, and like he has some friends....I am very nervous that this will through everything off, make it that much more difficult for him to learn, and/or he will have some sort of episode in front of all his 'new friends'....he has also started having bad headaches in the last few months. We have an appt. to get an MRI 'just in case', but the ped. neurologist thinks he has inherited my migraines....poor guy....I really don't know what more he can handle. We have to get another blood draw by the end of the week, so I will try to remember to post if the reduction in meds made a difference......
What a frustrating and awful ride for these little ones (and their parents!)
-MB
Older ds: generalized anxiety: no meds - meeting with a therapist once a week
Younger ds: BP, ADHD: Trileptal, Serequel, Strattera, possible migraines developing
Younger dd: fully engaged in "the terrible two's" - at least this one goes away on it's own - I hope :)
I hope the med changes help with the WBC problem. Has pdoc suggested referring you to a hematologist? If the problem persists, that would be the specialist to see.
My ds 14 developed migraines around that age. He was actually hospitalized for one once. We ended up putting him on Periactic (cyproheptadine), an old antihistamine, as a prophylactic med. He took it every night for a year. The HA's mostly went away, and then we were able to stop that med. He still gets HA's sometimes, but it's usually related to going too long between meals, being in bright sunlight, or getting dehydrated. Can't hurt to get the MRI, though.
DS16 used to get HA's when he was on Abilify, so I believe meds can definitely contribute to this problem.
Let us know how things go with the med changes and MRI.
--
Brenda,50, CABF Parent to Parent Volunteer
Mom to A, 16, BP, Tourette's, OCD, ADHD: Eskalith CR, Trilafon, Lamictal, Seroquel, Cytomel
E, 14, BP,AS, hypothyroidism: Seroquel, Eskalith CR, levothyroxin, inositol
B, 13 & H, 10
Married 17 years to DH, 49
If CABF has helped you, please help CABF. Donate today. http://www.bpkids.org/donate?campaign=forums2010
FROM CABF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.