ArticleTherapeutic advances in psychopharmacology2020
Management of clozapine treatment during the COVID-19 pandemic.
Article in Therapeutic advances in psychopharmacology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Clozapine Therapy and COVID-19: A Systematic Review of the Prevalence Rates, Health Outcomes, Hematological Markers, and Patient Perspectives.Schizophrenia bulletin · 2023Pooled it
- The Effect of COVID-19 Pandemic Restrictions on Laboratory Monitoring of Lithium Treated Outpatients in the Netherlands: A Controlled Interrupted Time Series Analysis.Pharmacoepidemiology and drug safety · 2026Article
- Adult psychiatrists' views on clozapine prescribing for schizophrenia in Germany-an online survey.Therapeutic advances in psychopharmacology · 2026Article
- Reduced SARS-CoV-2 vaccine-specific antibody response associated with high clozapine doses in schizophrenia spectrum disorders.Brain, behavior, & immunity - health · 2025Article
- Decoding Clozapine-Induced Agranulocytosis: Unraveling Interactions and Mitigation Strategies.Pharmacy (Basel, Switzerland) · 2024Article
- Clozapine Serum Concentrations Are Disrupted by SARS-CoV-2 Vaccinations.Case reports in psychiatry · 2023Article
- Starting clozapine in patients with schizophrenia during the ongoing pandemic.Schizophrenia research · 2022Article
- Management of mental health issues in Persons with Acute COVID-19 infection and during the post-COVID phase.Indian journal of psychiatry · 2022Article
- Clozapine treatment and risk of severe COVID-19 infection.Acta psychiatrica Scandinavica · 2022Article
- Clozapine and Neutropenia in Patients with Schizophrenia and SARS-CoV-2 Infection.Neuropsychiatric disease and treatment · 2022Article
- Challenges in Prescribing Clozapine in the Era of COVID-19: A Review Focused on Immunological Implications.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2021Review
- The potential interaction between COVID-19 vaccines and clozapine: A novel approach for clinical trials.International journal of clinical practice · 2021Article
- Transient drop in the neutrophil count during COVID-19 regardless of clozapine treatment in patients with mental illness.Revista de psiquiatria y salud mental · 2021Article
- Schizophrenia during the COVID-19 pandemic.Current opinion in psychiatry · 2021Review
- COVID-19 infection causes a reduction in neutrophil counts in patients taking clozapine.Journal of psychiatry & neuroscience : JPN · 2021Article
- Elevated clozapine levels and toxic effects after SARS-CoV-2 vaccination.Journal of psychiatry & neuroscience : JPN · 2021Article
- Implications of the COVID-19 pandemic for patients with schizophrenia spectrum disorders: narrative review.BJPsych open · 2021Article
- Ursodeoxycholic Acid in Patients With Treatment-Resistant Schizophrenia Suffering From Coronavirus Disease 2019: A Hypothesis Letter.Frontiers in psychiatry · 2021Article
- The effect of COVID-19 on absolute neutrophil counts in patients taking clozapine.Therapeutic advances in psychopharmacology · 2020Article
- A Basic Review of the Preliminary Evidence That COVID-19 Risk and Severity Is Increased in Vitamin D Deficiency.Frontiers in public health · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
Clozapine is the only available treatment for refractory schizophrenia but its use involves frequent physical contact with healthcare workers for the purpose of mandatory blood monitoring. During the COVID-19 pandemic, patients taking clozapine will be self-isolating to reduce the risk of infection, not least because these patients are at high risk of serious illness and fatality because of high rates of diabetes, obesity and pulmonary disease and an increased risk of pneumonia. Problems may also arise because both clozapine-induced myocarditis and neutropenic sepsis share signs and symptoms with COVID-19 (fever, chest pain, dyspnoea, etc.). We recommend decreasing the frequency of physical contacts by extending the blood monitoring interval to 12 weeks in those patients taking clozapine for more than 1 year. To distinguish COVID-19 from clozapine-related physical adverse effects, we suggest an urgent antigen test alongside a full blood count. In those taking clozapine who develop COVID-19, we suggest continuing with clozapine whenever possible (even during ventilation), reducing the dose if necessary in line with blood assay results. Blood monitoring should continue but clozapine should only cease if there is a significant fall in neutrophils (COVID-19 is linked to lymphopenia but not neutropenia). To protect against the likelihood and severity of respiratory infection, we recommend the use of vitamin D in all clozapine patients. Initiation of clozapine is likely to remain problematic while the risk of infection remains, given the degree of physical contact required to assure safety.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.