Psychosis Likely Induced by Hydroxychloroquine in a Patient With Chronic Q Fever: A Case Report and Clinically Relevant Review of Pharmacology

Das, Piyush; Rai, Abhishek; Chopra, Amit; Philbrick, Kemuel L.

doi:10.1016/j.psym.2013.06.017

Cited by 20 publications

(12 citation statements)

References 24 publications

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“…Chloroquine and hydroxychloroquine are known to cause a wide spectrum of neuropsychiatric manifestations, including agitation, insomnia, confusion, mania, hallucinations, paranoia, depression, catatonia, psychosis and suicidal ideation. 27 These can occur at all ages, 28 during acute or chronic use, [29][30][31][32] and in patients with and without a history of mental illness. 28,32 Resolution is expected upon stopping the drug, although symptoms may not resolve quickly.…”

Section: Neuropsychiatric Effectsmentioning

confidence: 99%

Safety considerations with chloroquine, hydroxychloroquine and azithromycin in the management of SARS-CoV-2 infection

Juurlink

2020

CMAJ

202

191

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Section: Neuropsychiatric Effectsmentioning

confidence: 99%

Safety considerations with chloroquine, hydroxychloroquine and azithromycin in the management of SARS-CoV-2 infection

Juurlink

2020

CMAJ

202

191

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“…Other antimalarial drugs such as chloroquine and mefloquine can cause neuropsychiatric side effects [20–24]. There are only a few case reports of psychosis due to HCQ [3, 18, 25, 26]. Our patient used a dose of HCQ equal to 4 mg/bodyweight/day; this dosage is within the therapeutic range.…”

Section: Discussionmentioning

confidence: 97%

“…At steady state, the ratio of HCQ to desethyl hydroxychloroquine was 1.75 ± 0.37 [10]. Cytochrome P450 3A4 inhibitors such as ketoconazole, cimetidine, and ciprofloxacin may increase the half-lives of HCQ [16, 17, 18]. The possible HCQ-induced neuropsychiatric side effects depend on its ability to cross the blood–brain barrier.…”

Section: Discussionmentioning

confidence: 99%

Psychomotor Agitation Following Treatment with Hydroxychloroquine

Manzo¹,

Gareri²,

Castagna³

2017

Drug Saf - Case Rep

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We describe the case of an elderly woman with elderly-onset rheumatoid arthritis, where the use of 4 mg/kg/day of hydroxychloroquine (HCQ) was followed by the onset of psychomotor agitation with marked physical and verbal violence towards her partner, including throwing objects at her partner. No disturbance in sleep and no anxiety, nervousness, or irritability had emerged before the onset of her psychomotor agitation. The disappearance of agitation following targeted pharmacologic intervention and HCQ interruption, its re-onset after reintroduction of the drug, and the high score (9) of Naranjo’s algorithm are surely linked to the existence of a causal relationship between HCQ and psychomotor agitation. HCQ may produce undesirable effects on the central nervous system, mainly irritability, nervousness, emotional changes, and nightmares. To the best of our knowledge, there are only a few case reports of psychosis due to HCQ. No favoring condition such as pharmacokinetic interactions or a personal and family psychiatric history was present in our patient. The neuropsychiatric manifestations we observed could be considered a bizarre-type adverse drug reaction linked to an individual’s hypersensitivity.

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“…These adverse events are doseindependent and may appear approximately within 2 hours or 40 days. They generally disappear within one week following discontinuation of the drug (6,(15)(16)(17). In their review, Mohan et al reported chloroquineinduced psychiatric adverse events in at least 10 cases between 1978 and 1980.…”

Section: Discussionmentioning

confidence: 99%

Hydroxychloraquine-induced acute psychotic disorder in a female patient with rheumatoid arthritis: a case report

Altıntaş¹

2015

Dusunen Adam

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Hydroxychloraquine-induced acute psychotic disorder in a female patient with rheumatoid arthritis: a case report Chloroquine and its derivative hydroxychloroquine (HCQ) have been used for acute and prophilactic treatment of malaria for most of the last century. HCQ has anti-inflammatory, antilipidemic and antithrombotic effects and in recent years has become an important drug for treating rheumatoid arthritis (RA). In the literature, antimalarial-induced psychosis has been reported in a small number of cases; however, we did not find any case related with HCQ-induced psychosis in rheumatoid arthritis. We want to report a 73-year-old female RA patient without a previous history of psychosis who developed psychosis after use of HCQ. HCQ is being increasingly prescribed in autoimmune diseases. Clinicians need to be aware of psychosis as a rare but debilitating side effect.

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Psychosis Likely Induced by Hydroxychloroquine in a Patient With Chronic Q Fever: A Case Report and Clinically Relevant Review of Pharmacology

Cited by 20 publications

References 24 publications

Safety considerations with chloroquine, hydroxychloroquine and azithromycin in the management of SARS-CoV-2 infection

Safety considerations with chloroquine, hydroxychloroquine and azithromycin in the management of SARS-CoV-2 infection

Psychomotor Agitation Following Treatment with Hydroxychloroquine

Hydroxychloraquine-induced acute psychotic disorder in a female patient with rheumatoid arthritis: a case report

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