Risperidone Induced Isolated Thrombocytopenia: A Rare Adverse Event

The rare odds, combined with a relatively safe hematological profile, often deter the physicians from making the connection between Risperidone and isolated thrombocytopenia. Quite possibly, this is the singular reason as to why an up-to-date scrutiny of medical literature revealed only one case of isolated thrombocytopenia with Risperidone.1 Thereby, it is our endeavor here to shed light on this potentially life-threatening and extremely rare adverse effect of Risperidone through this case report. A 42-year-old patient of paranoid schizophrenia, diagnosed at 14 years of age, presented to the psychiatry outpatient department (OPD) in August, 2015 with delusions of persecution and reference, anger outbursts and multiple episodes of intentional self-harm, since the past 6 months. Despite being on chronic treatment, a definitive drug history could only be ascertained from February 2015 when the patient was hospitalized and initiated on tablet Risperidone 2 mg twice daily and tablet Lorazepam 4 mg once daily. At that time patient’s hemoglobin was 9 g/dL (11–15 g/dL), white blood cell counts −3,700 cells/cu.mm. (4,000–11,000 cu.mm.) and platelets −1.8 lacs/cu.mm (1.5–4.5 lacs/cu.mm). Thereafter, routine follow ups until the episode in August 2015 revealed that the patient was maintaining well with Risperidone and Lorazepam for his underlying condition of paranoid schizophrenia.