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

BMC Medicine

Giuseppe Imperadore¹  Graham Thornicroft²  Alessandro Cuomo³  Andrea Fagiolini³  Taishiro Kishimoto⁴  Christoph Hiemke⁵  Robin Emsley⁶  Christoph U. Correll⁷  Georgios Schoretsanitis⁷  Dursun Serdar⁸  Brendon Stubbs⁹  David Taylor^1,10  Philip B. Ward^1,11  Federico Bertolini^1,12  Marianna Purgato^1,12  Michela Nosé^1,12  Francesco Amaddeo^1,12  Corrado Barbui^1,12  Giovanni Ostuzzi^1,12  Giulia Michencigh^1,12  Chiara Gastaldon^1,12  Davide Papola^1,12 

[1] Azienda ULSS 9 Scaligera;Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King’s College London;Department of Molecular Medicine, University of Siena;Department of Neuropsychiatry, Keio University School of Medicine;Department of Psychiatry and Psychotherapy, University Medical Center of Mainz;Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University;Department of Psychiatry, The Zucker Hillside Hospital;Department of Psychiatry, University of Alberta;Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London;Pharmacy Department, Maudsley Hospital;School of Psychiatry, UNSW Sydney and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research;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;

关键词: Novel coronavirus;    COVID-19;    Psychopharmacology;    Psychiatric comorbidity;    Drug–drug interactions;   

DOI  :  10.1186/s12916-020-01685-9

来源: DOAJ

【 摘 要 】

Abstract Background 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. Methods 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. Results 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. Conclusions 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.

【 授权许可】

Unknown