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Psychopharmacology of COVID-19.
Psychosomatics. 2020 Sep-Oct; 61(5):411-427.P

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.

Authors+Show Affiliations

Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY.Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY.Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY.Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY.Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: carrie.ernst@mssm.edu.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32425246

Citation

Bilbul, Melanie, et al. "Psychopharmacology of COVID-19." Psychosomatics, vol. 61, no. 5, 2020, pp. 411-427.
Bilbul M, Paparone P, Kim AM, et al. Psychopharmacology of COVID-19. Psychosomatics. 2020;61(5):411-427.
Bilbul, M., Paparone, P., Kim, A. M., Mutalik, S., & Ernst, C. L. (2020). Psychopharmacology of COVID-19. Psychosomatics, 61(5), 411-427. https://doi.org/10.1016/j.psym.2020.05.006
Bilbul M, et al. Psychopharmacology of COVID-19. Psychosomatics. 2020 Sep-Oct;61(5):411-427. PubMed PMID: 32425246.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psychopharmacology of COVID-19. AU - Bilbul,Melanie, AU - Paparone,Patricia, AU - Kim,Anna M, AU - Mutalik,Shruti, AU - Ernst,Carrie L, Y1 - 2020/05/18/ PY - 2020/04/24/received PY - 2020/05/11/revised PY - 2020/05/12/accepted PY - 2020/5/20/pubmed PY - 2020/10/6/medline PY - 2020/5/20/entrez KW - COVID-19 KW - psychopharmacology KW - psychotropic KW - side effects SP - 411 EP - 427 JF - Psychosomatics JO - Psychosomatics VL - 61 IS - 5 N2 - 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. SN - 1545-7206 UR - https://www.unboundmedicine.com/medline/citation/32425246/Psychopharmacology_of_COVID_19_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0033-3182(20)30144-4 DB - PRIME DP - Unbound Medicine ER -