Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2020 Jun;46(3):169-172.
doi: 10.1016/j.encep.2020.05.006. Epub 2020 May 16.

Repurposing chlorpromazine to treat COVID-19: The reCoVery study

M Plaze  1 , D Attali  2 , A-C Petit  3 , M Blatzer  4 , E Simon-Loriere  5 , F Vinckier  6 , A Cachia  7 , F Chrétien  8 , R Gaillard  9
Affiliations
Clinical Trial

Repurposing chlorpromazine to treat COVID-19: The reCoVery study

M Plaze et al. Encephale. 2020 Jun.

Abstract
in English, French

Objectives: The ongoing COVID-19 pandemic has caused approximately 2,350,000 infections worldwide and killed more than 160,000 individuals. In Sainte-Anne Hospital (GHU PARIS Psychiatrie & Neuroscience, Paris, France) we have observed a lower incidence of symptomatic forms of COVID-19 among patients than among our clinical staff. This observation led us to hypothesize that psychotropic drugs could have a prophylactic action against SARS-CoV-2 and protect patients from the symptomatic and virulent forms of this infection, since several of these psychotropic drugs have documented antiviral properties. Chlorpromazine (CPZ), a phenothiazine derivative, is also known for its antiviral activity via the inhibition of clathrin-mediated endocytosis. Recentin vitro studies have reported that CPZ exhibits anti-MERS-CoV and anti-SARS-CoV-1 activity.

Methods: In this context, the ReCoVery study aims to repurpose CPZ, a molecule with an excellent tolerance profile and a very high biodistribution in the saliva, lungs and brain. We hypothesize that CPZ could reduce the unfavorable course of COVID-19 infection among patients requiring respiratory support without the need for ICU care, and that it could also reduce the contagiousness of SARS-CoV-2. For this purpose, we plan a pilot, multicenter, randomized, single blind, controlled, phase III therapeutic trial (standard treatment vs. CPZ+standard treatment).

Conclusion: This repurposing of CPZ for its anti-SARS-CoV-2 activity could offer an alternative, rapid strategy to alleviate infection severity. This repurposing strategy also avoids numerous developmental and experimental steps, and could save precious time to rapidly establish an anti-COVID-19 therapy with well-known, limited and easily managed side effects.

Objectifs: La pandémie mondiale actuelle de COVID-19 a touché environ 2 350 000 personnes et fait plus de 160 000 morts. Nous avons observé dans le GHU PARIS Psychiatrie & Neurosciences (site Sainte-Anne, Paris, France) une incidence moins importante de formes symptomatiques de COVID-19 chez les patients que dans notre personnel soignant. Notre hypothèse est que les traitements psychotropes pourraient avoir une action prophylactique sur le SARS-CoV-2. Cette hypothèse est cohérente avec les propriétés antivirales connues de plusieurs psychotropes au premier rang desquels la chlorpromazine (CPZ). En plus de ses effets antipsychotiques classiques, plusieurs études in vitro ont également démontré une activité antivirale de cette phénothiazine via l’inhibition de l’endocytose dépendante des clathrines. Récemment, des études ont révélé un effet anti-MERS-CoV et anti-SARS-CoV-1 de la CPZ.

Méthodes: Dans ce contexte, l’étude reCoVery, basée sur le repositionnement de la CPZ – molécule avec un excellent profil de tolérance et une biodistribution très élevée dans la salive, les poumons et le cerveau – vise à tester l’hypothèse que la CPZ pourrait diminuer l’évolution défavorable de l’infection COVID-19 chez des patients oxygénorequérants sans nécessité de soins en réanimation mais aussi réduire la contagiosité du SARS-CoV-2. Nous allons réaliser pour cela un essai thérapeutique pilote de phase III multicentrique, randomisé, contrôlé (traitement standard vs CPZ + traitement standard) et en simple insu.

Conclusion: Le repositionnement de la CPZ comme antiviral anti-SARS-CoV-2 offre une stratégie alternative et rapide pour atténuer la propagation du virus ainsi que la gravité et la létalité du COVID-19.

Keywords: COVID-19; Chlorpromazine; Clinical trial; Essai clinique; Repositionnement de molécules; Repurposing of molecules; SARS-CoV-2.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Situation update worldwide, as of 20 April 2020. European Centre for Disease Prevention and Control.
    1. Delay J., Deniker P., Harl J.M. [Therapeutic use in psychiatry of phenothiazine of central elective action (4560 RP)] Ann Med Psychol (Paris) 1952;110:112–117. - PubMed
    1. Krizanová O., Ciampor F., Veber P. Influence of chlorpromazine on the replication of influenza virus in chick embryo cells. Acta Virol. 1982;26:209–216. - PubMed
    1. Hewlett I., Lee S., Molnar J., Foldeak S., Pine P.S., Weaver J.L. Inhibition of HIV infection of H9 cells by chlorpromazine derivatives. J Acquir Immune Defic Syndr Hum Retrovirol. 1997;15:16–20. - PubMed
    1. Pho M.T., Ashok A., Atwood W.J. JC virus enters human glial cells by clathrin-dependent receptor-mediated endocytosis. J Virol. 2000;74:2288–2292. - PMC - PubMed

Publication types

MeSH terms