Post Covid Encephalitis Lethargica managed with Tofisopam 2021


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Role of Tofisopam in Post COVID Neuro-psychiatric Sequelae: A Case Series - Jigyansa ipsita Pattnaik, Deepthi R. A., Shivani Dua, Prasanta Padhan, Jayaprakash Russell Ravan, 2021 (
Tofisopam, a 2,3-benzodiazepine (2,3- BDZs) with a common chemical backbone to “classical” 1,4-benzodiazepines, does not interact with the classical benzodiazepine binding site of the GABA receptor.14

Its nonsedative, non-hypotensive property, without any respiratory suppression, could have provided the added advantage in the post-COVID-19 state.15

The mixed dopamine agonist–antagonist property of tofisopam probably modulates the hypo-dopaminergic state in catatonia.

Tofisopam does not impair intellectual performance as other benzodiazepines do. In contrast, it has a cognitive stimulatory activity.16

The anti-amnesic effects of tofisopam, with concomitant improvements in hippocampal synaptogenesis, neurogenesis, and glial plasticity, have been found in animal studies.17

Besides, tofisopam has been reported to have an antidepressant property, possibly by sharing a mechanism similar to Serotonin Norepinephrine Reuptake Inhibitors via phosphodiesterase 4 inhibition.18

This inhibitory action of tofisopam on PDE has potential therapeutic benefits of cognitive enhancement, improving anxiety, and psycho-energetic effect, without attention impairment.19