Consensus statement on the use of clozapine during the COVID-19 pandemic

With the ongoing coronavirus disease 2019 (COVID-19) pandemic, psychiatrists find themselves in the clinical situation of being asked by patients, family members and patient advocacy societies to help ensure access to clozapine as a medication critical for ongoing patient care. To provide clozapine...

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Bibliographic Details
Published in:Journal of psychiatry & neuroscience 2020-05, Vol.45 (3), p.222-223
Main Authors: Siskind, Dan, Honer, William G, Clark, Scott, Correll, Christoph U, Hasan, Alkomiet, Howes, Oliver, Kane, John M, Kelly, Deanna L, Laitman, Robert, Lee, Jimmy, MacCabe, James H, Myles, Nick, Nielsen, Jimmi, Schulte, Peter F, Taylor, David, Verdoux, Helene, Wheeler, Amanda, Freudenreich, Oliver
Format: Article
Language:English
Subjects:
Antipsychotic Agents - adverse effects
Antipsychotic Agents - therapeutic use
Betacoronavirus
Child & adolescent psychiatry
Clinical Laboratory Techniques
Clozapine
Clozapine - adverse effects
Clozapine - therapeutic use
Consensus
Coronavirus Infections - blood
Coronavirus Infections - diagnosis
Coronavirus Infections - etiology
Coronaviruses
COVID-19
COVID-19 Testing
Drug dosages
Fever
Grants
Health services
Hospitals
Humans
Immune response
Infections
Medicine
Mental health
Metabolites
Mortality
Neutropenia
Neutropenia - chemically induced
Neutropenia - complications
Neutrophils
Pandemics
Patients
Pneumonia, Viral - blood
Pneumonia, Viral - diagnosis
Pneumonia, Viral - etiology
Psychopharmacology for the Clinician
Psychosis
Psychotropic drugs
Royalties
Saliva
SARS-CoV-2
Schizophrenia
Schizophrenia - blood
Schizophrenia - complications
Schizophrenia - drug therapy
Severe acute respiratory syndrome coronavirus 2
Systematic review
Telemedicine
Toxicity
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Description
Summary:With the ongoing coronavirus disease 2019 (COVID-19) pandemic, psychiatrists find themselves in the clinical situation of being asked by patients, family members and patient advocacy societies to help ensure access to clozapine as a medication critical for ongoing patient care. To provide clozapine prescribing guidance and facilitate regulatory agencies modifying laboratory monitoring and/or dispensing requirements, an expert advisory subgroup of the Treatment Response and Resistance in Psychosis working group developed the following background, recommendations and rationale as a consensus statement. Clozapine may be associated with a higher risk of pneumonia, likely due to sialorrhea and aspiration rather than neutropenia. Clozapine-associated neutropenia is thought to occur as a result of selective neutrophil toxicity mediated by clozapine N-oxide metabolites,7 or an immune response mediated by a hapten-based mechanism, 8 both of which occur early in exposure.
ISSN:1180-4882
1488-2434
DOI:10.1503/jpn.200061