Clozapine
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COVID-19 infection: case report A 51-year-old man developed COVID-19 infection during treatment with clozapine for schizoaffective disorder. The man, who had been monitored for ultra-chemo-resistant schizoaffective disorder from the age of 25 years, had been hospitalised for 18 months until January 2020. He was stable psychiatrically on combination treatment with clozapine 600mg daily (since February 2019) [route not stated] along with paliperidone [paliperidone palmitate], sodium valproate and extended-release lithium [lithium carbonate]. On 24 march 2020, he presented to the hospital with fever, fatigue and a persistent cough that had lasted for 3 days. Therefore, he was quarantined; however, he found it difficult to be quarantined due to his smoking habit in spite of application of nicotine patches. On 26 March 2020, he was found to be COVID-19 positive and was transferred to the COVID positive unit. On the same day, laboratory investigations revealed polymorphonuclear neutrophils (PMN) 4760 n/mm3 and WBC count 7700 n/mm3. The man’s dose of clozapine was reduced to 400mg. His clinical course became rapidly favourable. On 09 April 2020, his laboratory investigations revealed PMN 4140 n/mm3 and WBC count 8120 n/mm3. On the same day (14 days following onset of symptoms), he returned to the normal unit. The dose of clozapine was then gradually changed back to the 600mg daily due to schizoaffective disorder. On 17 April 2020, his laboratory investigations revealed PMN 3930 n/mm3 and WBC count 6680 n/mm3. Bouaziz N, et al. Thoughts on a favourable evolution of a COVID-19 in a patient with resistant schizophrenia and on a combination of clozapine and paliperidone palmitate. 803498022 L’Encephale 46: S126-S127, No. 3, Jun 2020. Available from: URL: http://doi.org/10.1016/j.encep.2020.05.009 [French; summarised from a translation]
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Reactions 29 Aug 2020 No. 1819
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