Psychotropic drugs and COVID-19: therapeutic management

Abstract

In March 2020, the World Health Organization (WHO) declared a pandemic due to the SARS-CoV-2/COVID-19 virus. At the beginning of 2021, it was recorded 83,715,617 confirmed cases and 1,835,901 deaths by COVID-19. Thus, a worldwide effort was made to develop effective protocols to treat this disease. One of the difficulties was the heterogeneity with which COVID-19 affects different patients due to comorbidities. The lack of specific drugs to treat COVID-19 is worrying. This situation is even worst when we consider possible interactions between these drugs and those previously used, mainly those of chronic use. In this context are patients with psychiatric disorders, such as Major Depressive Disorder (MDD), Bipolar Affective Disorder (BAD), and Schizophrenia. This work aimed to identify the most cited drugs in COVID-19 treatment and evaluate their interactions with drugs described in treatment protocols for mood and psychotic disorders. A narrative review of the most cited drugs for COVID-19 in different stages of the disease on safety and efficacy in patients on treatment for depression, bipolar disorder, and schizophrenia was made. Non-clinical trials, trials without results, articles that present later retraction, articles written in unfamiliar foreign languages to the authors, and vaccine-related articles and immune therapy were excluded because they are out of the scope of this study. After exclusions, 117 studies were considered. The most cited drugs were Hydroxychloroquine/Chloroquine (26 articles), followed by tocilizumab (10 articles), ivermectin and remdesivir (8 articles each), and favipiravir (7 articles). Hydroxychloroquine/chloroquine showed several conflicting results and was the drug most associated with drug interactions in all studied drugs.