Severe Clozapine-Induced Agranulocytosis, Pharmacodynamic Synergism, and Lithium Promyelocytic Effects in Granulocyte Colony-Stimulating Factor (G-CSF) Resistance or Delayed Response: A Case Report.

Clozapine-induced agranulocytosis is documented in multiple studies, but there is limited literature on treatment-resistant agranulocytosis, the synergistic effect of multiple agranulocytosis-inducing drugs, and lithium's promyelocytic effects. This case highlights these gaps by discussing a patient with an absolute neutrophil count of zero while being treated with Depakote, Haldol, and clozapine. This case proposes more research on lithium's promyelocytic effects, especially in patients who are unresponsive or have a delayed response to discontinuing offending agents and granulocyte colony-stimulating factor (G-CSF).

Seizure detection watch improves quality of life for adolescents and their families.

This article reports the findings from a pilot study conducted to explore the impact of using a wearable seizure detection device on quality of life for 10 adolescents with epilepsy and their parents. Quality of life in Epilepsy for Adolescent (QOLIE AD-48) and the Parent Response to Child Illness (PRCI) Scale were compared at study onset and 6 months after using the SmartWatch seizure detection device. At the conclusion of the study, a qualitative interview explored the adolescent's and parent's experiences with using the device. In this sample, the wearable seizure detection device was well accepted as a means to increase seizure safety for both adolescents and their caregivers. In addition, adolescents and parents felt more secure with the adolescent increasing independent activities when wearing the watch. Barriers to use included technical difficulties, such as false alarms, and the burden of adding another aspect to their epilepsy care. While these data cannot be generalized to all populations, findings suggest that further research with wearable seizure detection devices is warranted. Considering current sudden unexplained death from epilepsy (SUDEP) prevention guidelines that encourage seizure monitoring, especially during sleep, the wearable seizure detection device may provide adequate seizure monitoring without the negative consequences to the adolescent's developing autonomy.