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Agranulocytosis is a severe hematologic complications of clozapine, but risperidone was not shown to induce agranulocytois. Nevertheless, some cases of risperidone-induced agranulocytosis were being reported, but there was no report yet in Korea. Recently we experienced that a female patient taking risperidone suffered by fever and agranulocytosis, so treated by discontinuation of risperidone and granulocyte-colony stimulating factor (G-CSF). A 54 year-old depressed and psychotic women started a treatment with risperidone. On hospital day 11, agranulocytosis accompanied with fever developed. Risperidone was discontinued and G-CSF was administered. On hospital day 13, the hematologic complication was improved. Thereafter olanzapine was administerd for treatment of psychotic symptoms. On hospital day 41, the patient discharged with normal hematologic profile and improved state of depressive and psychotic symptoms. Agranulocytosis induced by risperidone is not frequent, but it can develop in some vulnerable patients. So, if a patient taking risperidone shows fever, chill, sore throat, hematologic examination should be carried out. Once agranulocytosis develops, immediate discontinuation of risperidone and other potential drug. Thereafter, preventive antibiotics and shortening in duration of aganulocytosis are needed.
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