Neurotoxicity

There are currently thought to be some adverse effects on the CNS system due to treatment with hydroxychloroquine. These include:

• Headaches^1,2

• Dizziness²

• Increased anxiety²

• Tinnitus^3,4

• Insomnia⁴

• Seizures^1,2

• Visual disturbances¹

• Psychosis (although this is currently thought to be very rare)^2,3.

There are some case studies that have also documented myasthenia gravis and muscle weakness⁴. There may also be some central and peripheral neuronal damage associated with treatment with HCQ, but prevalence is unknown⁵.

References:

1.DrugBank. Hydroxychloroquine [Online]. 2021. [Date accessed: 17/11/2021]. Available from: https://go.drugbank.com/drugs/DB01611

2. Ali S & Jones H. 23. An adverse neuropsychiatric reaction following treatment with Hydroxychloroquine: a case report. Rheumatology Advances in Practice. 2018, 2(1), pp i16-i17.

3. Chansky P & Werth V. Accidental Hydroxychloroquine overdose resulting in neurotoxic vestibulopathy. BMJ Case Reports. 2017. pp 1-3.

4. Ilowite N & Laxer R. PHARMACOLOGY AND DRUG THERAPY. In: Cassidy J, Laxer R, Petty R, & Lindsley C. eds. Textbook of Pediatric Rheumatology. Philadelphia. Saunders Elvesier, 2010, pp 76-126.

5. Muller R. Systemic toxicity of chloroquine and hydroxychloroquine: prevalence, mechanisms, risk factor, prognostic and screening possibilities. Rheumatology International. 2021, 41, pp1189-1202.