Antipsychotic Use Increases Infection Risk During COVID-19 - EMJ

Antipsychotic Use Increases Infection Risk During COVID-19

A NEW study has revealed that people with schizophrenia spectrum disorders who are treated with antipsychotic medications face an increased risk of severe respiratory infections, particularly during the COVID-19 pandemic. The study analysed data from over 85,000 individuals with schizophrenia in Denmark between March 2020 and December 2021 to assess the impact of antipsychotic drugs on infection outcomes. 

Key findings showed that while antipsychotic use slightly decreased the risk of a positive COVID-19 test (by 9%), the risk of COVID-19-related hospitalisations was significantly higher (28%) in patients exposed to antipsychotic medications compared to non-exposed periods. Similarly, non-COVID respiratory infections were linked to even greater risks, with a 61% increased likelihood of hospitalisation and death during antipsychotic treatment. 

The study found that these risks were more pronounced in older age groups, with individuals over 40 facing higher rates of non-COVID respiratory infections and those aged 50-79 at a greater risk of death. Notably, the researchers did not observe an elevated risk specifically associated with clozapine, an antipsychotic that has been debated for its safety during large-scale infection outbreaks. 

The study’s authors recommend proactive infection prevention measures, such as pneumococcal vaccination, particularly for individuals over 40 who are undergoing antipsychotic treatment. However, they emphasise that the use of specific antipsychotic medications should not be avoided, and that healthcare providers should continue to follow treatment guidelines while remaining vigilant about infection risks in this vulnerable group. 

Aleksandra Zurowska, EMJ 

Reference 

Nersesjan V et al. Antipsychotic exposure and infection risk in people with schizophrenia spectrum disorders during the COVID-19 pandemic: a Danish nationwide registry study. Lancet Psych. 2024;11(10):796-806. 

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