Role of Tofisopam in Post COVID Neuro-psychiatric Sequelae: A Case Series

Abstract

A 52-year-old businessman, with no contributory medical or neuropsychiatric comorbidities, was hospitalized for COVID-19 pneumonia. He received conservative management as per COVID-19 treatment guidelines and was discharged after a week. Within a week of the discharge, he reported being withdrawn, having decreased interaction with family members, remaining mute for hours together, hypersomnolence, and sometimes would not swallow the chewed food. He was brought to the psychiatric outpatient department for evaluation. On Mini Mental State Examination, he scored 24 out of 27. In the Bush Francis Catatonia Rating Scale, the score was 24, with higher scores in the domains of mutism, verbal fluency, and negativism. EEG and MRI brain were normal. In view of catatonia and recent recovery from COVID pneumonia, a benzodiazepine without respiratory suppression effect, tofisopam, was administered at a dose of 100 mg/per day, in divided doses, for two weeks. No respiratory

Antioxidant Activity and Cytotoxicity against Cancer Cell Lines of the Extracts from Novel Xylaria Species Associated with Termite Nests and LC-MS Analysis

“…In addition, tofisopam (peak no. 28) from the extracts of X. vinacea SWUF18-2.3 was reported as synthetic compounds and has anxiolytic activity [67] and recently reported as post COVID neuro-psychiatric sequelae [68]. Isolation of new species of fungal metabolites may lead to the development of a new class of anticancer drugs through further study.…”

Update of the Potential Treatments for Psychiatric and Neuropsychiatric Symptoms in the Context of the Post-COVID-19 Condition: Still a Lot of Suffering and Many More Things to Learn

“…Studies comparing the efficiency of antidepressants between a post-COVID-19 group and a control group should be useful. Tofisopam should be assessed for post-COVID-19 symptoms because of its interesting pharmacological profile [47]. Psychostimulants such as lisdexamfetamine [47] should be considered with caution because of the addictive risk.…”

“…Tofisopam should be assessed for post-COVID-19 symptoms because of its interesting pharmacological profile [47]. Psychostimulants such as lisdexamfetamine [47] should be considered with caution because of the addictive risk.…”

“…Some authors tested tofisopam, a 2,3-benzodiazepine (2,3-BDZs) with a common chemical backbone to "classical" 1,4-benzodiazepines that does not interact with the classical benzodiazepine binding site of the GABA receptor, in a case series of three cases of post-COVID-19 patients. The cases showed potential therapeutic properties of tofisopam because of its anxiolytic effects in anxiety and depression, without sedative and muscle relaxant side effects, its antiamnestic properties, and its effects for both positive and negative symptoms of psychosis [47].…”

Rational Approach to Psychotropic Use in COVID-19 Cases With Psychiatric Comorbidities: Lesson Learnt From a Case Series

“…Although evidence is limited, tofisopam was thus preferred over lorazepam. 12 , 13 Additional possibilities include considering the use of benzodiazepines for a short duration to improve sleep and reduce autonomic panic symptoms, which would aid recovery in mild to moderate COVID patients with severe anxiety or insomnia. Nonjudicious use of benzodiazepines may lead to respiratory depression and drug dependence.…”