Deterioration of COVID-19 vaccine efficacy by antipsychotic medications in schizophrenia patients

ABSTRACT It has been previously documented that some antipsychotic medications could deteriorate the protective efficacy of vaccines. Likewise, we have initially observed that a significantly increased number of schizophrenic inpatients became ill irrespective of COVID-19 vaccination compared to hea...

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Main Authors: Takashi Kusunoki, Naomi Tsubata, Nariaki Iijima, Shiho Mitsugi, Toru Nagasaka, Takeshi Senga, Ryoichi Ichie, Takashi Okamoto
Format: Article
Language:English
Published: American Society for Microbiology 2025-05-01
Series:Microbiology Spectrum
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Online Access:https://journals.asm.org/doi/10.1128/spectrum.00021-25
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author Takashi Kusunoki
Naomi Tsubata
Nariaki Iijima
Shiho Mitsugi
Toru Nagasaka
Takeshi Senga
Ryoichi Ichie
Takashi Okamoto
author_facet Takashi Kusunoki
Naomi Tsubata
Nariaki Iijima
Shiho Mitsugi
Toru Nagasaka
Takeshi Senga
Ryoichi Ichie
Takashi Okamoto
author_sort Takashi Kusunoki
collection DOAJ
description ABSTRACT It has been previously documented that some antipsychotic medications could deteriorate the protective efficacy of vaccines. Likewise, we have initially observed that a significantly increased number of schizophrenic inpatients became ill irrespective of COVID-19 vaccination compared to healthy hospital workers. Thus, we examined the effects of anti-psychiatric medication on the COVID-19 incidence. A cohort study was conducted with 98 schizophrenia inpatients and 78 control hospital staff members, all of whom received the COVID-19 vaccine between July and September 2021. COVID-19 incidence and vaccine-related side effects were compared between these two groups. The schizophrenia group had a significantly higher incidence of COVID-19 (40.8%) compared to the control group (12.8%) (P < 0.01). In particular, risperidone monotherapy was associated with a significant increase in COVID-19 incidence (65.6%), whereas aripiprazole use was linked to a significant reduction (0%) (P < 0.01). No such difference in COVID-19 incidence was observed in patients using olanzapine. Risperidone administration appears to impair the immune responses and reduce vaccine effectiveness. Further studies with extended subjects and other vaccines are warranted to clarify the anti-vaccine effects associated with risperidone.IMPORTANCEThe vaccine efficacy in this study is significant because it sheds light on the potential impact of antipsychotic medications, particularly risperidone, on the effectiveness of COVID-19 vaccines in individuals with schizophrenia. The findings suggest that patients treated with risperidone have a significantly higher risk of incidence of COVID-19 despite vaccination, highlighting a possible interference with immune responses. In contrast, aripiprazole appears to have a protective effect, and the combined use of both medications results in an alarming increase in COVID-19 incidence. These results underscore the importance of further investigating the immunological mechanisms underlying these effects, especially through the dopamine receptor activity. Understanding these interactions could lead to more effective vaccination strategies and better healthcare management for patients with schizophrenia, ensuring better protection against COVID-19 and other infectious diseases.
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spelling doaj-art-3db5efdd9acc405e930b6ab573bc9b762025-08-20T02:11:30ZengAmerican Society for MicrobiologyMicrobiology Spectrum2165-04972025-05-0113510.1128/spectrum.00021-25Deterioration of COVID-19 vaccine efficacy by antipsychotic medications in schizophrenia patientsTakashi Kusunoki0Naomi Tsubata1Nariaki Iijima2Shiho Mitsugi3Toru Nagasaka4Takeshi Senga5Ryoichi Ichie6Takashi Okamoto7Junwakai Yahagigawa Hospital, Anjo, Aichi, JapanJunwakai Yahagigawa Hospital, Anjo, Aichi, JapanJunwakai Yahagigawa Hospital, Anjo, Aichi, JapanJunwakai Yahagigawa Hospital, Anjo, Aichi, JapanJunwakai Yahagigawa Hospital, Anjo, Aichi, JapanJunwakai Yahagigawa Hospital, Anjo, Aichi, JapanJunwakai Yahagigawa Hospital, Anjo, Aichi, JapanJunwakai Yahagigawa Hospital, Anjo, Aichi, JapanABSTRACT It has been previously documented that some antipsychotic medications could deteriorate the protective efficacy of vaccines. Likewise, we have initially observed that a significantly increased number of schizophrenic inpatients became ill irrespective of COVID-19 vaccination compared to healthy hospital workers. Thus, we examined the effects of anti-psychiatric medication on the COVID-19 incidence. A cohort study was conducted with 98 schizophrenia inpatients and 78 control hospital staff members, all of whom received the COVID-19 vaccine between July and September 2021. COVID-19 incidence and vaccine-related side effects were compared between these two groups. The schizophrenia group had a significantly higher incidence of COVID-19 (40.8%) compared to the control group (12.8%) (P < 0.01). In particular, risperidone monotherapy was associated with a significant increase in COVID-19 incidence (65.6%), whereas aripiprazole use was linked to a significant reduction (0%) (P < 0.01). No such difference in COVID-19 incidence was observed in patients using olanzapine. Risperidone administration appears to impair the immune responses and reduce vaccine effectiveness. Further studies with extended subjects and other vaccines are warranted to clarify the anti-vaccine effects associated with risperidone.IMPORTANCEThe vaccine efficacy in this study is significant because it sheds light on the potential impact of antipsychotic medications, particularly risperidone, on the effectiveness of COVID-19 vaccines in individuals with schizophrenia. The findings suggest that patients treated with risperidone have a significantly higher risk of incidence of COVID-19 despite vaccination, highlighting a possible interference with immune responses. In contrast, aripiprazole appears to have a protective effect, and the combined use of both medications results in an alarming increase in COVID-19 incidence. These results underscore the importance of further investigating the immunological mechanisms underlying these effects, especially through the dopamine receptor activity. Understanding these interactions could lead to more effective vaccination strategies and better healthcare management for patients with schizophrenia, ensuring better protection against COVID-19 and other infectious diseases.https://journals.asm.org/doi/10.1128/spectrum.00021-25schizophreniaantipsychoticsrisperidonearipiprazoleolanzapineCOVID-19 vaccination
spellingShingle Takashi Kusunoki
Naomi Tsubata
Nariaki Iijima
Shiho Mitsugi
Toru Nagasaka
Takeshi Senga
Ryoichi Ichie
Takashi Okamoto
Deterioration of COVID-19 vaccine efficacy by antipsychotic medications in schizophrenia patients
Microbiology Spectrum
schizophrenia
antipsychotics
risperidone
aripiprazole
olanzapine
COVID-19 vaccination
title Deterioration of COVID-19 vaccine efficacy by antipsychotic medications in schizophrenia patients
title_full Deterioration of COVID-19 vaccine efficacy by antipsychotic medications in schizophrenia patients
title_fullStr Deterioration of COVID-19 vaccine efficacy by antipsychotic medications in schizophrenia patients
title_full_unstemmed Deterioration of COVID-19 vaccine efficacy by antipsychotic medications in schizophrenia patients
title_short Deterioration of COVID-19 vaccine efficacy by antipsychotic medications in schizophrenia patients
title_sort deterioration of covid 19 vaccine efficacy by antipsychotic medications in schizophrenia patients
topic schizophrenia
antipsychotics
risperidone
aripiprazole
olanzapine
COVID-19 vaccination
url https://journals.asm.org/doi/10.1128/spectrum.00021-25
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