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Revisiting Clozapine in a Setting of COVID-19

Received: 16 July 2020    Accepted: 28 July 2020    Published: 18 August 2020
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Abstract

Clozapine is a highly potent atypical antipsychotic popularly used for treating refractory schizophrenia. Clozapine displays a complex mechanism of action. There are emerging views that its mode of action is immunomodulation rather than neuromodulation. It must be the immunomodulatory properties of clozapine that contributes to its superior efficacy and such a view help to validate the autoimmune ethology of a subset of schizophrenia. Agranulocytosis, one of the major side effects of clozapine is thought to be an autoimmune reaction. Because higher incidence of Flu related complications has been reported among clozapine users, there has been concern about the impact of COVID-19 among the patients on clozapine. As in the case of general population, infections with SARS-CoV-2 have been reported among clozapine users, but these are early days to make any firm conclusions about the higher risks of COVID-19 posing to clozapine treated patients. It is possible that clozapine may have therapeutic effects other than its antipsychotic effect and that needs further exploration.

Published in American Journal of Psychiatry and Neuroscience (Volume 8, Issue 3)
DOI 10.11648/j.ajpn.20200803.12
Page(s) 46-54
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Clozapine, Neuromodulation, Immunomodulation, Agranulocytosis, COVID-19, Autoimmune Reaction

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Cite This Article
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    James Paul Pandarakalam. (2020). Revisiting Clozapine in a Setting of COVID-19. American Journal of Psychiatry and Neuroscience, 8(3), 46-54. https://doi.org/10.11648/j.ajpn.20200803.12

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    James Paul Pandarakalam. Revisiting Clozapine in a Setting of COVID-19. Am. J. Psychiatry Neurosci. 2020, 8(3), 46-54. doi: 10.11648/j.ajpn.20200803.12

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    AMA Style

    James Paul Pandarakalam. Revisiting Clozapine in a Setting of COVID-19. Am J Psychiatry Neurosci. 2020;8(3):46-54. doi: 10.11648/j.ajpn.20200803.12

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  • @article{10.11648/j.ajpn.20200803.12,
      author = {James Paul Pandarakalam},
      title = {Revisiting Clozapine in a Setting of COVID-19},
      journal = {American Journal of Psychiatry and Neuroscience},
      volume = {8},
      number = {3},
      pages = {46-54},
      doi = {10.11648/j.ajpn.20200803.12},
      url = {https://doi.org/10.11648/j.ajpn.20200803.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajpn.20200803.12},
      abstract = {Clozapine is a highly potent atypical antipsychotic popularly used for treating refractory schizophrenia. Clozapine displays a complex mechanism of action. There are emerging views that its mode of action is immunomodulation rather than neuromodulation. It must be the immunomodulatory properties of clozapine that contributes to its superior efficacy and such a view help to validate the autoimmune ethology of a subset of schizophrenia. Agranulocytosis, one of the major side effects of clozapine is thought to be an autoimmune reaction. Because higher incidence of Flu related complications has been reported among clozapine users, there has been concern about the impact of COVID-19 among the patients on clozapine. As in the case of general population, infections with SARS-CoV-2 have been reported among clozapine users, but these are early days to make any firm conclusions about the higher risks of COVID-19 posing to clozapine treated patients. It is possible that clozapine may have therapeutic effects other than its antipsychotic effect and that needs further exploration.},
     year = {2020}
    }
    

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    T1  - Revisiting Clozapine in a Setting of COVID-19
    AU  - James Paul Pandarakalam
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    AB  - Clozapine is a highly potent atypical antipsychotic popularly used for treating refractory schizophrenia. Clozapine displays a complex mechanism of action. There are emerging views that its mode of action is immunomodulation rather than neuromodulation. It must be the immunomodulatory properties of clozapine that contributes to its superior efficacy and such a view help to validate the autoimmune ethology of a subset of schizophrenia. Agranulocytosis, one of the major side effects of clozapine is thought to be an autoimmune reaction. Because higher incidence of Flu related complications has been reported among clozapine users, there has been concern about the impact of COVID-19 among the patients on clozapine. As in the case of general population, infections with SARS-CoV-2 have been reported among clozapine users, but these are early days to make any firm conclusions about the higher risks of COVID-19 posing to clozapine treated patients. It is possible that clozapine may have therapeutic effects other than its antipsychotic effect and that needs further exploration.
    VL  - 8
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  • North West Boroughs Healthcare NHS Foundation Trust & AFG Rehab Hospitals, Hollins Park Hospital, Warrington, UK

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