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Clozapine is strongly associated with the risk of pneumonia and inflammation

查看全文 作  者:Jose de [1]Leon;Can-Jun [2]Ruan;Helene [3]Verdoux;Chuanyue [2]Wang 高影响力作者 机构地区:[1]University of Kentucky Mental Health Research Center,Eastern State Hospital,Lexington,Kentucky,USA;[2]Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospital,Beijing,China;[3]Inserm,Bordeaux Population Health Research Center,University of Bordeaux Faculty of Medical Sciences,Bordeaux,Aquitaine,France高影响力机构 出  处:《General Psychiatry》索引2020年第33卷第2期,共7页高影响力期刊 摘  要: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. 关 键 词:INFLAMMATION PNEUMONIA MORTALITY
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