Use of chloroquine / hydroxychloroquine and risk of suicide: hypotheses of confluent etiopathogenetic mechanisms?

This article was originally published here

Behav Sci (Basel). November 7, 2021; 11 (11): 154. doi: 10.3390 / bs11110154.

ABSTRACT

Chloroquine (CQ) and hydroxychloroquine (HCQ) are classic antimalarial and anti-inflammatory treatments, which were used as first-line treatment at the onset of the 2019 coronavirus disease (COVID-19) pandemic. In addition to emerging data on their lack of efficacy against COVID-19 infection, such treatments have been linked to serious health problems, including those of a neuropsychiatric nature, such as a possible increased risk of suicide. Here we report the case of a patient with no history of psychiatric illness, who suddenly developed depression with melancholic features, severe suicidal ideation (SI) and a suicide attempt (SA) shortly after receiving HCQ for his infection with COVID-19. The case was followed by a mini-review of the heterogeneous scientific literature on the hypothetical association between neuropsychiatric symptoms, with an emphasis on SI and suicidal behavior (SB, including AS and death by suicide), when CQ and HCQ are used in COVID-19, rheumatologic diseases and malaria settings. Considering the anti-inflammatory properties of CQ and HCQ and the implications for neuroinflammation in the pathogenesis of suicide, the possible increase in suicide risk caused by these drugs seems paradoxical and suggests that other underlying pathological trajectories could. explain this possibility. In this regard, some of the latter mechanistic postulates have been proposed. Certainly, the role and contribution of psychosocial factors that a COVID-19 patient has had to deal with cannot be minimized or excluded in the attempt to understand their suffering until the development of SI / SB. However, although this case report represents a rare scenario in clinical practice and there is no consensus in the literature on this topic, psychiatric screening for suicide risk in patients using CQ and HCQ could be carefully considered. considered.

PMID:34821615 | DO I:10.3390 / bs11110154


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