AGRANULOCYTOSIS ASSOCIATED WITH PROMAZINE ADMINISTRATION: REPORT OF THREE CASES

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Abstract
While agranulocytosis has been reported with chlorpromazine, only two previous reports of its occurrence with use of promazine have appeared to date. This paper describes 3 more such cases. Dosages ranged from 2.75 g in 31 days to 11.7 g intermittently over a 6-month period. Presenting symptoms included fever, cough, sore throat and diarrhea. Lowest white cell count ranged from 200 to 900/mm3. Therapy included penicillin, streptomycin and dihydro-streptomycin, broad spectrum antibiotics, nystatin, and prednisone. One patient expired from a monilial infection. The others recovered. Possible mechanisms are discussed, with high dosages and prolonged exposures favoring a possible toxic mode of action. Therapeutic measures are mentioned, and the literature briefly reviewed.