ArticleTherapeutic advances in psychopharmacology2020
Clozapine prescribing in COVID-19 positive medical inpatients: a case series.
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 19 papers, 2 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 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
- Toxicity of psychotropic drugs in patients with COVID-19: A systematic review.General hospital psychiatryPooled it
- Drug-Drug Interactions Between COVID-19 Treatments and Psychotropic Medications: An Updated Study.Cureus · 2023Review
- COVID-19: Brain Effects.The Psychiatric clinics of North America · 2022Review
- COVID-related hospitalization, intensive care treatment, and all-cause mortality in patients with psychosis and treated with clozapine.European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology · 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
- Neutropenia after the coadministration of clozapine and nirmatrelvir-ritonavir in a patient with SARS-CoV-2 infection: A case report with a literature review.Frontiers in psychiatry · 2022Article
- Psychotropics and COVID-19: An analysis of safety and prophylaxis.L'Encephale · 2021Article
- Rational Approach to Psychotropic Use in COVID-19 Cases With Psychiatric Comorbidities: Lesson Learnt From a Case Series.Indian journal of psychological medicine · 2021Article
- Reduction in Absolute Neutrophil Counts in Patient on Clozapine Infected with COVID-19.International journal of environmental research and public health · 2021Review
- 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
- Transient drop in the neutrophil count during COVID-19 regardless of clozapine treatment in patients with mental illness.Revista de psiquiatria y salud mentalArticle
- A Covid-19 outbreak in a Spanish long-term psychiatric hospital led to infections in 6 clozapine patients: elevations in their plasma clozapine levels.Revista de psiquiatria y salud mentalArticle
- A Covid-19 outbreak in a Spanish long-term psychiatric hospital led to infections in 6 clozapine patients: elevations in their plasma clozapine levels.Revista de psiquiatria y salud mentalArticle
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
There is both uncertainty regarding the safety of clozapine in COVID-19 patients owing to limited published data and a lack of consensus on continuing clozapine in patients with severe respiratory infections. COVID-19 is known to induce an acute immune response which can affect haematological parameters associated with clozapine monitoring, and systemic infection may reduce clozapine clearance. Clozapine, which has been associated with worse outcomes in some pneumonias, may in theory worsen outcomes in COVID-19. Despite these concerns, there are some data to indicate it is safe to continue clozapine in COVID-19 infection. In this retrospective case series, we describe our experiences of clozapine prescribing and disease progression of eight SARS-CoV-2 positive patients on medical wards in a major London teaching hospital. In four cases clozapine was stopped during the hospital admission. A COVID-19 pneumonia developed in four patients: three of these required intensive care unit admission for an average of 34 days. At the time of writing, three patients had died (two directly from COVID-19 pneumonia), two remained in general hospital wards, two were recovering in the community and one had been transferred to an inpatient psychiatric hospital. Follow-up length varied but in each case was not more than 104 days. Delirium was the most common adverse neuropsychiatric event, and in one case a relapse of psychosis occurred after cessation of clozapine. This retrospective case series illustrates the safe use of clozapine during COVID-19 infection. Our experiences suggest that consideration should be made to continuing clozapine even in those most unwell with COVID-19. We also identify areas which require larger scale hypothesis-testing research.
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