Systematic Review of Psychiatric Adverse Effects Induced by Chloroquine and Hydroxychloroquine: Case Reports and Population Studies

Talarico, Fernanda; Chakravarty, Sucheta; Liu, Yang S.; Greenshaw, Andrew J.; Passos, Ives Cavalcante; Cao, Bo

doi:10.1177/10600280221113572

Cited by 3 publications

(3 citation statements)

References 77 publications

(181 reference statements)

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“…Earlier studies have suggested that HCQ can lead to psychiatric side effects like emotional lability, anxiety symptoms and even psychotic breakdowns. 30 In the present study, patients who were receiving HCQ reported higher scores on PHQ-9 and PHQ-15. As this was a cross-sectional study, it is difficult to draw a cause-effect relationship, but these findings suggest that there is a need to screen SLE patients for psychiatric morbidity, before starting HCQ.…”

Section: Discussionsupporting

confidence: 46%

Psychiatric comorbidities in patients suffering from systemic lupus erythematosus admitted to a tertiary care hospital in Northern India

Grover

Sahoo

Naskar

et al. 2023

Lupus

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Background Systemic Lupus Erythematosus (SLE) is an autoimmune disease with multiorgan involvement presenting with a myriad of symptoms, including neuropsychiatric symptoms. Although many studies have evaluated screening questionnaires based psychiatric morbidity, very few studies have used contemporary diagnostic criteria. Objective This study aimed to evaluate the prevalence of psychiatric disorders in patients with SLE admitted to a tertiary care hospital. Methods A total of 79 patients diagnosed with SLE for at least for 1 year, who were not in delirium were assessed by a qualified psychiatrist for psychiatric morbidity as per the International Classification of Diseases, 10th Revision (ICD-10) criteria. Additionally, these patients were assessed on Patient Health Questionnaire-9 (PHQ-9) item version, Patient Health Questionnaire-15 (PHQ-15) item version, Generalized Anxiety Disorder-7 item scale and Montreal Cognitive Assessment (MoCA). Results 51% ( n = 40) of the participants were diagnosed with a psychiatric diagnosis, with depressive disorders being the most common, seen in 36.7% ( n = 29) of the participants. Additionally, 10% ( n = 8) participants were diagnosed with adjustment disorder and 2.5% ( n = 2) were diagnosed with anxiety (not otherwise specified). Only one patient was diagnosed with organic psychosis. On PHQ-9, 39.8% ( n = 33) were diagnosed with depression. 44.3% ( n = 35) expressed death wishes and/or suicidal ideations. On PHQ-15, 17.7% ( n = 14) of the participants scored for severe somatic distress (score >15). On GAD-7, 55.7% ( n = 44) screened positive for anxiety symptoms, but only 7.6% ( n = ) had a score of 15 or more to indicate severe anxiety. Nearly half ( n = 43; 52%) of the participants also had cognitive impairment as assessed on MoCA, with 13.3% ( n = 11) of the participants having scores indicating severe dementia. Conclusions Patients with SLE have a high prevalence of psychiatric comorbidities and should be routinely screened for psychiatric morbidity. They should be appropriately treated, to improve the overall treatment outcomes.

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Section: Discussionsupporting

confidence: 46%

Psychiatric comorbidities in patients suffering from systemic lupus erythematosus admitted to a tertiary care hospital in Northern India

Grover

Sahoo

Naskar

et al. 2023

Lupus

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“…Notably, there is evidence suggesting a direct relationship between acute psychosis and antibiotic exposure, with macrolides and fluoroquinolones presenting the greatest increased odds of psychosis [ 61 ]. Similarly, for the antimalarial hydroxychloroquine, which was one of the most promising therapies tested in patients with COVID-19 at the beginning of the pandemic, a documented association with neuropsychiatric adverse effect, including acute psychosis, is well established [ 62 , 63 , 64 , 65 ]. Hydroxychloroquine typically crosses the blood–brain barrier to concentrate within the CNS [ 66 , 67 , 68 , 69 ].…”

Section: Covid-19 and New-onset Psychosis: Possible Confoundersmentioning

confidence: 99%

COVID-19 and New-Onset Psychosis: A Comprehensive Review

Moccia

Kotzalidis

Bartolucci

et al. 2023

JPM

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Psychosis is a multifactorial condition that typically involves delusions, hallucinations, and disorganized thought, speech or behavior. The observation of an association between infectious epidemics and acute psychosis dates back to the last century. Recently, concerns have been expressed regarding COVID-19 and the risk for the development of new-onset psychosis. This article reviewed the current evidence of a possible link between SARS-CoV-2 and risk of psychosis as an acute or post-infectious manifestation of COVID-19. We here discuss potential neurobiological and environmental factors as well as a number of challenges in ascribing a causal pathogenic relationship between SARS-CoV-2 infection and new-onset psychosis.

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“…This issue can be explained by the low prevalence of neuropsychiatric side effects of SSZ and HCQ, as well as the short duration of treatment in previous studies. Nonetheless, in patients receiving SSZ/HCQ over a long period of time, it is possible to identify neuropsychiatric side effects [14].…”

Section: Introductionmentioning

confidence: 99%

How Different Is The Status Of Depression And Anxiety In Patients With Rheumatoid Arthritis Receiving Methotrexate With Sulfasalazine Or Hydroxychloroquine?

Babaei,

Dorparvar,

Ghahari

et al. 2023

Russ Open Med J

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Background — Depression and anxiety are among the most common clinical manifestations in patients with rheumatoid arthritis (RA). Sulfasalazine and hydroxychloroquine are important medications used to treat these patients. Objective — The goal of this study was to compare the occurrence of depression and anxiety in RA patients taking sulfasalazine or hydroxychloroquine for at least six months. Methods — This study included 300 patients with RA referred to inpatient or outpatient departments of a public hospital in northern Iran who were treated with two combination regimens of methotrexate and sulfasalazine or methotrexate and hydroxychloroquine. Participants were assessed on the standard Hospital Anxiety and Depression Scale (HADS) for symptoms of depression and anxiety. Results — The mean HADS depression subscale score was 6.77±3.98 in the hydroxychloroquine group and 3.50±3.53 in the sulfasalazine group (p<0.001). The mean HADS anxiety subscale score was 7.66±4.43 in the hydroxychloroquine group and 5.34±4.35 in the sulfasalazine group (p<0.001). Multiple linear regression analysis revealed a significant difference in the incidence of depression and anxiety between the two treatment groups. Conclusion — A higher prevalence of depression and anxiety was observed in RA patients treated with methotrexate and hydroxychloroquine versus those treated with methotrexate with sulfasalazine.

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Systematic Review of Psychiatric Adverse Effects Induced by Chloroquine and Hydroxychloroquine: Case Reports and Population Studies

Cited by 3 publications

References 77 publications

Psychiatric comorbidities in patients suffering from systemic lupus erythematosus admitted to a tertiary care hospital in Northern India

Psychiatric comorbidities in patients suffering from systemic lupus erythematosus admitted to a tertiary care hospital in Northern India

COVID-19 and New-Onset Psychosis: A Comprehensive Review

How Different Is The Status Of Depression And Anxiety In Patients With Rheumatoid Arthritis Receiving Methotrexate With Sulfasalazine Or Hydroxychloroquine?

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