Hydroxychloroquine tablets. (Illustration) - AFP

Neuropsychiatric disorders followed by a suicide attempt. The Spanish Medicines Agency (AEMPS) alerted the Medicines Agency (ANSM) after the suicide of three patients treated with Covid-19 by hydroxychloroquine. AEMPS has counted six known cases of Covid-19 patients treated with hydroxychloroquine who had neuropsychiatric disorders, including three suicides and one suicide attempt. These neuropsychiatric disorders appeared mainly during the first days of treatment, at high doses, including in patients with no psychiatric history. The French agency, for its part, had no report of serious neuropsychiatric disorders comparable to this date. But reports of adverse effects of treatments linked to Covid-19 reach more than 500 cases, announced the ANSM.

The agency recalls that the risk of neuropsychiatric disorders is already known with hydroxychloroquine and chloroquine (psychosis, nervousness, insomnia, depression, etc.) and could be aggravated by the context linked to the pandemic and confinement. An evaluation on this subject is underway at European level.

With regard to the other undesirable effects monitored, the ANSM notes that "the number of cardiac undesirable effects of treatments with hydroxychloroquine alone or in combination has seen a less significant increase compared to the previous weeks". It reports a fairly significant drop in its use both in town and in hospitals.

The majority of cardiac adverse reactions linked to hydroxychloroquine

In all, "as of May 12, 562 cases of adverse reactions have been reported in connection with an infection with Covid-19, including 78% of serious cases, concerning 64% of men," details the ANSM, which had announced more than 300 cases on April 25 and a hundred on April 10. Among these cases, 348 (62%) are attributed to the drugs used in the treatment of Covid-19, the other cases being divided between drugs that may have aggravated the disease (12%) and cases related to other drugs prescribed for these patients (25%).

Hydroxychloroquine (Plaquenil) accounts for the majority of cardiac adverse reactions, or 141 out of 159 cases. The cardiac effects of hydroxychloroquine account for 69% of its undesirable effects (hepatic, digestive ...) listed against 44% for Kaletra (an antiretroviral combining lopinavir and ritonavir).

Electrical abnormalities in the functioning of the heart

Hydroxychloroquine, a derivative of the antimalarial chloroquine, is known to cause electrical abnormalities in the functioning of the heart in some patients that can be seen on the EKG, which can lead to heart rhythm disturbances or even death. It seems that "Covid patients are more fragile cardiovascular and therefore more likely than ordinary people to have problems with drugs that are harmful to the heart" such as hydroxychloroquine, explained the director general of ANSM Dominique Martin at AFP in early April.

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The number of deaths all linked to hydroxychloroquine occurring in hospitals is always four. In view of these risks, the health agency recalls that these drugs, when used against Covid-19, must be used as a priority in the context of ongoing clinical trials.

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