Emerging and experimental treatments for COVID-19 and drug interactions with psychotropic agents

Bishara, Delia; Kalafatis, Chris; Taylor, David

doi:10.1177/2045125320935306

Cited by 44 publications

(53 citation statements)

References 25 publications

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“…Neutropenia and its extreme form agranulocytosis can occur with a variety of antipsychotics and mood-stabilizers, particularly with clozapine and carbamazepine ( 43 ). Some of the agents used to treat COVID-19 infection such as chloroquine, hydroxychloroquine, azithromycin, and lopinavir can also cause neutropenia ( 44 ). Hence, individuals with SMD taking such agents need careful monitoring ( 45 ).…”

Section: Discussionmentioning

confidence: 99%

“…These psychotropic agents may become problematic in combination with somatic drugs also increasing QT interval, used for treating a COVID-19 infection. The latter group includes some antibiotics and antiarrhythmics, chloroquine, hydroxychloroquine and the antiviral and histamin-2 antagonist famotidine ( 44 ). It currently remains unclear how often such interactions with psychotropic drugs occur in the context of COVID-19 treatment.…”

Section: Discussionmentioning

confidence: 99%

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Death Associated With Coronavirus (COVID-19) Infection in Individuals With Severe Mental Disorders in Sweden During the Early Months of the Outbreak—An Exploratory Cross-Sectional Analysis of a Population-Based Register Study

et al. 2021

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Background: Individuals with severe mental disorder (SMD) have a higher risk of somatic comorbidity and mortality than the rest of the population. We set up a population-based study to assess whether individuals with SMD had a higher risk of death associated with a COVID-19 infection (COVID-19 associated death) than individuals without SMD.Methods: Exploratory analysis with a cross-sectional design in the framework of a population-based register study covering the entire Swedish population. The Swedish Board for Health and Welfare (Socialstyrelsen) provided anonymized tabulated summary data for further analysis. We compared numbers of COVID-19 associated death in individuals with SMD (cases) and without SMD (controls). We calculated the odds ratio (OR) for the whole sample and by age group and four comorbidities, namely diabetes, cardiovascular disease, hypertension, chronic lung disease.Results: The sample comprised of 7,923,859 individuals, 103,999 with SMD and 7,819,860 controls. There were 130 (0.1%) COVID-19 associated deaths in the SMD group and 4,945 (0.06%) in the control group, corresponding to an OR of 1.98 (CI 1.66-2.35; p < 0.001). The odds were 4-fold for the age groups between 60 and 79 years and 1.5-fold for cardiovascular diseases. Individuals with SMD without any of the risk factors under study had 3-fold odds of COVID-19 associated death.Conclusion: Our preliminary results identify individuals with SMD as a further group at increased risk of COVID-19 associated death. In regard to comorbidities, future studies should explore the potential confounding or mediation role in the relationship between SMD and COVID-19 associated deaths.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Death Associated With Coronavirus (COVID-19) Infection in Individuals With Severe Mental Disorders in Sweden During the Early Months of the Outbreak—An Exploratory Cross-Sectional Analysis of a Population-Based Register Study

et al. 2021

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“…37 Some of the agents used to treat COVID-19 infection such as chloroquine, hydroxychloroquine, azithromycin, and lopinavir can also cause neutropenia. 38 Hence, individuals with SMD taking such agents need careful monitoring. 39 QT prolongation is a potentially dangerous adverse effect increasing the risk of torsade de pointes and current cardiac death.…”

Section: Other Risk Factors Which May Specifically Associated With Sementioning

confidence: 99%

“…The latter group includes some antibiotics and antiarrhythmics, chloroquine, hydroxychloroquine and the antiviral and histamin-2 antagonist famotidine. 38 preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in The copyright holder for this this version posted September 18, 2020. ; https://doi.org/10.1101/2020.09.14.20193987 doi: medRxiv preprint 15 (25) bipolar disorder or major depression. 40 In part, this increased risk is associated with psychotropic medications.…”

Section: Other Risk Factors Which May Specifically Associated With Sementioning

confidence: 99%

Death associated with coronavirus (COVID-19) infection in individuals with severe mental disorders in Sweden during the early months of the outbreak – a exploratory cross-sectional analysis of a population-based register study

Maripuu

Bendix

Öhlund

et al. 2020

Preprint

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Background: Individuals with severe mental disorder (SMD) have a higher risk of somatic comorbidity and mortality than the rest of the population. We set up a population-based study to assess whether individuals with SMD had a higher risk of death associated with a COVID-19 infection (COVID-19 associated death) than individuals without SMD. Methods: Exploratory analysis with a cross-sectional design in the framework of a population-based register study covering the entire Swedish population. The Swedish Board for Health and Welfare (Socialstyrelsen) provided anonymised tabulated summary data for further analysis. We compared numbers of COVID-19 associated death in individuals with SMD (cases) and without SMD (controls). We calculated the odds ratio (OR) for the whole sample and by age group and four potential risk factors, namely diabetes, cardiovascular disease, hypertension, chronic lung disease. Results: The sample comprised of 7,923,859 individuals, 103,999 with SMD and 7,819,860 controls. There were 130 (0.1%) COVID-19 associated deaths in the SMD group and 4945 (0.06%) in the control group, corresponding to an OR of 1.98 (CI 1.66-2.35; p < 0.001). The odds were fourfold in the age group between 60 and 79 years. Cardiovascular diseases increased the odds by 50%. Individuals with SMD without any of the risk factors under study had three-folds odds of COVID-19 associated death. Conclusion: Our preliminary results suggest that individuals with SMD are a further group at increased risk of COVID-19 associated death. The factors contributing to this increased mortality risk require clarification.

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“…Lopinavir is metabolized by hepatic CYP3A enzyme while ritonavir is both metabolized by and inhibits this same enzyme, increasing the plasma levels of lopinavir and itself (22). Although in a pharmacokinetics study by Arshad et al (25), LPV/r was predicted to achieve lung concentrations over 10-fold higher than reported EC50, but another recent study stated that LPV/r with poor lung distributions subsequently failed to inhibit viral replication at least in the lungs (26).…”

Section: Protease Inhibitorsmentioning

confidence: 99%

Antiretrovirals for Prophylaxis Against COVID‐19: A Comprehensive Literature Review

Alavian

Kolahdouzan

Mortezazadeh

et al. 2020

The Journal of Clinical Pharma

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Although people living with human immunodeficiency virus(PLWH) and other comorbidities are expected to experience griever consequences with COVID-19, recent cohort studies do not indicate this. Antiretrovirals(ARVs) might have a prophylactic role in these patients. The purpose of this study is to review the most recently published articles on the possible role of ARVs for pre or post-exposure prophylaxis against COVID-19. From June to October 2020, we searched scientific databases using specific keywords to identify ongoing trials or articles published before October 2020 investigating any subgroups of ARVs for prophylaxis against COVID-19. Apart from molecular docking studies, in vitro, animal, and human studies are very limited for evaluating the prophylactic role of ARVs against SARS-CoV-2 infection. According to our findings, there is no definite evidence to support use of protease inhibitors for this purpose, despite the promising results of molecular studies and limited clinical evidence for ritonavir boosted lopinavir, darunavir, and nelfinavir when used early in the course of the disease. Nucleotide/nucleoside reverse transcriptase inhibitors(NRTI) also have shown binding affinity to SARS-CoV-2 main enzymes in molecular, in vitro and animal studies. NRTIs like tenofovir and emtricitabine might exhibit prophylactic role against SARS-CoV-2 infection. In This article is protected by copyright. All rights reserved. conclusion, currently there is no evidence to justify the use of ARVs for prophylaxis against COVID-19.

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Emerging and experimental treatments for COVID-19 and drug interactions with psychotropic agents

Cited by 44 publications

References 25 publications

Death Associated With Coronavirus (COVID-19) Infection in Individuals With Severe Mental Disorders in Sweden During the Early Months of the Outbreak—An Exploratory Cross-Sectional Analysis of a Population-Based Register Study

Death Associated With Coronavirus (COVID-19) Infection in Individuals With Severe Mental Disorders in Sweden During the Early Months of the Outbreak—An Exploratory Cross-Sectional Analysis of a Population-Based Register Study

Death associated with coronavirus (COVID-19) infection in individuals with severe mental disorders in Sweden during the early months of the outbreak – a exploratory cross-sectional analysis of a population-based register study

Antiretrovirals for Prophylaxis Against COVID‐19: A Comprehensive Literature Review

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