The Ignored Psychiatric Aspect of Chloroquine in the COVID-19 Outbreak Period: A Narrative Review Study

Abstract

Context: Several studies have shown that chloroquine can effectively diminish the replication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As such, other studies have also supported this statement, but the psychiatric side effects of chloroquine have not been taken into account. Objectives: The current study aimed to briefly review and discuss the safety of chloroquine. Evidence Acquisition: A narrative literature search on databases was carried out on studies without time limitations. A combination of the two main keywords of “Chloroquine” and “Psychiatric Side Effects” was used to search databases. A manual search was performed to find the relevant articles, and finally, 15 studies were reviewed. Data were shown in the table and then summarized by narrative synthesis. Results: The literature review revealed the pharmaceutical characteristics of chloroquine, the safety of chloroquine, and the management of chloroquine's side effects. Also, the studies showed that chloroquine had psychiatric symptoms varying from insomnia to catatonia, toxic psychosis, and suicidal attempts, as well as behavioral manifestations, including most frequently extreme irritability, restlessness, abusiveness, distractibility, pressured speech, flight of ideas, grandiosity delusion, and auditory and visual hallucinations. Conclusions: Given the probability of a wide range of possible psychiatric symptoms following chloroquine, physicians should cautiously prescribe antiviral agents, and healthcare workers should also notice any psychiatric symptoms after administrating the chloroquine.