Safety of psychotropic medications in people with COVID-19: evidence review and practical recommendations.

Journal: BMC medicine

Volume: 18

Issue: 1

Year of Publication: 2020

Affiliated Institutions:  WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy. giovanni.ostuzzi@univr.it. WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy. Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA. Department of Molecular Medicine, University of Siena, Siena, Italy. Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, , South Africa. Azienda ULSS Scaligera, Verona, Italy. Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan. Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada. Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK. Pharmacy Department, Maudsley Hospital, London, UK. Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. School of Psychiatry, UNSW Sydney and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia. Department of Psychiatry and Psychotherapy, University Medical Center of Mainz, Mainz, Germany.

Abstract summary 

The novel coronavirus pandemic calls for a rapid adaptation of conventional medical practices to meet the evolving needs of such vulnerable patients. People with coronavirus disease (COVID-19) may frequently require treatment with psychotropic medications, but are at the same time at higher risk for safety issues because of the complex underlying medical condition and the potential interaction with medical treatments.In order to produce evidence-based practical recommendations on the optimal management of psychotropic medications in people with COVID-19, an international, multi-disciplinary working group was established. The methodology of the WHO Rapid Advice Guidelines in the context of a public health emergency and the principles of the AGREE statement were followed. Available evidence informing on the risk of respiratory, cardiovascular, infective, hemostatic, and consciousness alterations related to the use of psychotropic medications, and drug-drug interactions between psychotropic and medical treatments used in people with COVID-19, was reviewed and discussed by the working group.All classes of psychotropic medications showed potentially relevant safety risks for people with COVID-19. A set of practical recommendations was drawn in order to inform frontline clinicians on the assessment of the anticipated risk of psychotropic-related unfavorable events, and the possible actions to take in order to effectively manage this risk, such as when it is appropriate to avoid, withdraw, switch, or adjust the dose of the medication.The present evidence-based recommendations will improve the quality of psychiatric care in people with COVID-19, allowing an appropriate management of the medical condition without worsening the psychiatric condition and vice versa.

Authors & Co-authors:  Ostuzzi Giovanni G Papola Davide D Gastaldon Chiara C Schoretsanitis Georgios G Bertolini Federico F Amaddeo Francesco F Cuomo Alessandro A Emsley Robin R Fagiolini Andrea A Imperadore Giuseppe G Kishimoto Taishiro T Michencigh Giulia G Nosé Michela M Purgato Marianna M Dursun Serdar S Stubbs Brendon B Taylor David D Thornicroft Graham G Ward Philip B PB Hiemke Christoph C Correll Christoph U CU Barbui Corrado C

Study Outcome 

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Statistics
Citations :  Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020. 10.1001/jama.2020.2648. Online ahead of print.
Authors :  22
Identifiers
Doi : 215
SSN : 1741-7015
Study Population
Male,Female
Mesh Terms
Betacoronavirus
Other Terms
COVID-19;Drug–drug interactions;Novel coronavirus;Psychiatric comorbidity;Psychopharmacology
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
England