Article ; Online: Psychopharmacology of COVID-19.
2020 Volume 61, Issue 5, Page(s) 411–427
Abstract: Background: With the rapid, global spread of severe acute respiratory syndrome coronavirus 2, hospitals have become inundated with patients suffering from coronavirus disease 2019. Consultation-liaison psychiatrists are actively involved in managing ... ...
| Abstract | Background: With the rapid, global spread of severe acute respiratory syndrome coronavirus 2, hospitals have become inundated with patients suffering from coronavirus disease 2019. Consultation-liaison psychiatrists are actively involved in managing these patients and should familiarize themselves with how the virus and its proposed treatments can affect psychotropic management. The only Food and Drug Administration-approved drug to treat COVID-19 is remdesivir, and other off-label medications used include chloroquine and hydroxychloroquine, tocilizumab, lopinavir/ritonavir, favipiravir, convalescent plasma therapy, azithromycin, vitamin C, corticosteroids, interferon, and colchicine. Objective: To provide an overview of the major safety considerations relevant to clinicians who prescribe psychotropics to patients with COVID-19, both related to the illness and its proposed treatments. Methods: In this targeted review, we performed structured literature searches in PubMed to identify articles describing the impacts of COVID-19 on different organ systems, the neuropsychiatric adverse effects of treatments, and any potential drug interactions with psychotropics. The articles most relevant to this one were included. Results: COVID-19 impacts multiple organ systems, including gastrointestinal, renal, cardiovascular, pulmonary, immunological, and hematological systems. This may lead to pharmacokinetic changes that impact psychotropic medications and increase sensitivity to psychotropic-related adverse effects. In addition, several proposed treatments for COVID-19 have neuropsychiatric effects and potential interactions with commonly used psychotropics. Conclusions: Clinicians should be aware of the need to adjust existing psychotropics or avoid using certain medications in some patients with COVID-19. They should also be familiar with neuropsychiatric effects of medications being used to treat this disease. Further research is needed to identify strategies to manage psychiatric issues in this population. |
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| MeSH term(s) | Adenosine Monophosphate/adverse effects ; Adenosine Monophosphate/analogs & derivatives ; Adenosine Monophosphate/therapeutic use ; Adrenal Cortex Hormones/adverse effects ; Adrenal Cortex Hormones/therapeutic use ; Alanine/adverse effects ; Alanine/analogs & derivatives ; Alanine/therapeutic use ; Amides/adverse effects ; Amides/therapeutic use ; Anti-Inflammatory Agents/adverse effects ; Anti-Inflammatory Agents/therapeutic use ; Antibodies, Monoclonal, Humanized/adverse effects ; Antibodies, Monoclonal, Humanized/therapeutic use ; Antiviral Agents/adverse effects ; Antiviral Agents/therapeutic use ; Ascorbic Acid/adverse effects ; Ascorbic Acid/therapeutic use ; Azithromycin/adverse effects ; Azithromycin/therapeutic use ; Betacoronavirus ; COVID-19 ; Chloroquine/adverse effects ; Chloroquine/therapeutic use ; Colchicine/adverse effects ; Colchicine/therapeutic use ; Coronavirus Infections/complications ; Coronavirus Infections/drug therapy ; Coronavirus Infections/metabolism ; Coronavirus Infections/therapy ; Drug Combinations ; Drug Interactions ; Humans ; Hydroxychloroquine/adverse effects ; Hydroxychloroquine/therapeutic use ; Immunization, Passive ; Interferons/adverse effects ; Interferons/therapeutic use ; Lopinavir/adverse effects ; Lopinavir/therapeutic use ; Mental Disorders/chemically induced ; Mental Disorders/complications ; Mental Disorders/drug therapy ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/drug therapy ; Pneumonia, Viral/metabolism ; Psychotropic Drugs/adverse effects ; Psychotropic Drugs/metabolism ; Psychotropic Drugs/therapeutic use ; Pyrazines/adverse effects ; Pyrazines/therapeutic use ; Ritonavir/adverse effects ; Ritonavir/therapeutic use ; SARS-CoV-2 ; Vitamins/adverse effects ; Vitamins/therapeutic use |
| Chemical Substances | Adrenal Cortex Hormones ; Amides ; Anti-Inflammatory Agents ; Antibodies, Monoclonal, Humanized ; Antiviral Agents ; Drug Combinations ; Psychotropic Drugs ; Pyrazines ; Vitamins ; lopinavir-ritonavir drug combination ; Lopinavir (2494G1JF75) ; remdesivir (3QKI37EEHE) ; Adenosine Monophosphate (415SHH325A) ; Hydroxychloroquine (4QWG6N8QKH) ; Azithromycin (83905-01-5) ; Chloroquine (886U3H6UFF) ; Interferons (9008-11-1) ; favipiravir (EW5GL2X7E0) ; tocilizumab (I031V2H011) ; Ritonavir (O3J8G9O825) ; Alanine (OF5P57N2ZX) ; Ascorbic Acid (PQ6CK8PD0R) ; Colchicine (SML2Y3J35T) |
| Keywords | covid19 |
| Language | English |
| Publishing date | 2020-05-18 |
| Publishing country | England |
| Document type | Journal Article ; Review |
| ZDB-ID | 209487-3 |
| ISSN | 1545-7206 ; 0033-3182 |
| ISSN (online) | 1545-7206 |
| ISSN | 0033-3182 |
| DOI | 10.1016/j.psym.2020.05.006 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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