DE LEON, J.; RUAN, C. J.; VERDOUX, Helene; WANG, C.

doi:10.1136/gpsych-2019-100183

Bordeaux population health [BPH]

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Article de revue

Ce document a été publié dans

General Psychiatry. 2020, vol. 33, n° 2, p. e100183

Résumé en anglais

Clinicians need to remember that (1) systemic inflammations can increase clozapine level; (2) clozapine, by itself, can cause inflammation, particularly during titration that is too rapid for that patient; (3) clozapine may increase the risk of infection; and (4) more specifically, clozapine may be particularly strongly associated with the risk of pneumonia. Pneumonia appears to be associated with high mortality in clozapine patients around the world. Clinicians who are alert to the risk of pneumonia in clozapine patients may significantly decrease mortality in clozapine patients. There is no data on COVID-19 infections in clozapine patients, but based on what we know about clozapine pharmacology, we can hypothesise that clozapine, possibly by impairing immunological mechanisms, may increase the risk of pneumonia in infected patients. More importantly, once fever and/or pneumonia develops, the clozapine dose should be cut in half to decrease the risk of clozapine intoxication. If there is any doubt that in spite of halving the dose there are still signs of clozapine intoxication, completely stopping clozapine may be indicated. Once the signs of inflammation and fever have disappeared, the clozapine dose can be increased to the prior dosage level.< Réduire

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PharmacoEpi-Drugs

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https://oskar-bordeaux.fr/handle/20.500.12278/25934

DOI

http://dx.doi.org/10.1136/gpsych-2019-100183

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Bordeaux Population Health Research Center (BPH) - UMR 1219

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Clozapine is strongly associated with the risk of pneumonia and inflammation

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Résumé en anglais

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