Researchers at the United Arab Emirates University (UAEU) have proposed using an antipsychotic drug to combat COVID-19. “Since 1954, we have been using Chlorpromazine to treat illnesses such as schizophrenia and different types of psychosis,” said Emmanuel Stip, Professor and Chair of the Psychiatry Department at the UAE University. “Chlorpromazine (CPZ) is a well-established antipsychotic medication that has recently been proposed to have antiviral activity against SARS-CoV-2, the virus that causes Coronavirus disease (COVID-19)”. Prof. Stip has studied the drug’s history for many years and observed its anti-infectious properties. When COVID-19 developed into a global health emergency in early 2020, he became interested in the effect of the virus penetrating the cells in the body. “It is often a question of how viruses cross the cell membrane,” he explained, “for instance, we worked on receptors in the membrane to help the cell reject the virus.” In a recent paper, Prof. Stip and colleagues explained that some drugs used as antiviral medication have neuropsychiatric side effects, and conversely some psychotropic drugs have antiviral properties. “This medication, originally discovered in France and called Largactil, has the ability to work against different viruses, such as adenovirus, Hepatitis C and HIV in both in-vitro laboratory studies and in animals,” Prof. Stip noted. “Based on these results, we have proposed a local clinical trial in the UAE for investigating the use of CPZ in the treatment of COVID-19. There have already been some papers in Europe on the topic as well as clinical trials in France and Egypt.”
The early stages of infection with coronavirus are critical in the course of the viral cycle, particularly the manner in which the virus enters the cell. This is the first step in the interaction between the virus and the cell that can initiate, maintain, and spread the infection. “There is a protein called Clathrin which opens the membranes and allows the virus to enter the cells. But if we can block this step as Chlorpromazine does, the virus will not be able to get into the cells and cause disease. If we can block entry to the cell in laboratory conditions, then it will be a natural next step to see if it works on people with COVID-19.” The possible mechanism of action of CPZ is related to virus cell entry via clathrin-mediated endocytosis. Therefore, CPZ could be useful to treat COVID-19 patients provided its efficacy is evaluated in adequate and well-conducted clinical trials. There are currently about 15 laboratories around the world trying to work out how CPZ effects the cell membrane. Immunologists and biochemists at the UAEU recently met in a bid to bring together all established basic scientific knowledge from these experiments and plan the clinical trial protocol. “It could prove ground-breaking because although it would be very good to have a vaccine, successful anti-viral drugs would provide great benefit to patients who do develop COVID-19.” Virologists and basic scientists are currently testing CPZ against the virus, although it has not yet been tested in a COVID-19 human clinical trial.
Prof. Stip pointed out that “the most vulnerable COVID-19 patients are those with psychiatric disorders. Psychotic patients suffer much more often than the general population from comorbidities such as cardiovascular pathologies, diabetes, obesity, and smoking which are all risk factors for severe SARS-CoV-2 infection. So we want to try using Chlorpromazine to protect them against the virus while providing psychotropic effects, partially replacing their current medication.” Many different compounds have already been tested against COVID-19, but without much success. “It is difficult to have a strong effect on the viral charge,” he noted. “But what is interesting is to see that there are some molecules which act against the first step of the viral invasion. He wants to bring hope to people all over the world by demonstrating different levels of biological action and scientific research at multiple levels of laboratory experiments and clinical trials. “The goal is to try to build a very complete army against the virus,” Prof. Stip concluded. “It’s a combination of preventing the cell becoming infected and avoiding the virus spreading to millions of cells.” Through his research activities, Prof. Stip aims to inform healthcare professionals and scientists about the historical use of Chlorpromazine in psychiatry and propose a research protocol for investigating its effectiveness in the treatment of COVID-19. In the end, “it is interesting that the domain of psychiatry might come to the rescue of virology.”
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