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Volume 38, issue 1

Review article

The effect of psychotropic drugs on the occurrence and course of COVID-19

Janusz Rybakowski1
1. Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Klinika Psychiatrii Dorosłych, Uniwersytet Medyczny w Poznaniu, Poznań, Polska
Farmakoterapia w Psychiatrii i Neurologii 2022, 38 (1), 9–21.
Date of publication: 28-07-2022
DOI: https://doi.org/10.5114/fpn.2022.117697
Keywords: COVID-19, antidepressants, fluvoxamine, antipsychotics, lithium

Abstract

Objective. The aim of this paper is the presentation of current experimental and clinical data on psychotropic drugs in patients with COVID-19 infection as well as the review of the literature from 2020–2022 on the effects of antidepressants, antipsychotics, mood stabilisers and other drugs on the occurrence and course of COVID-19 infection. Some of them exert the antiviral effect on SARS-CoV-2, some can diminish the risk, and some can act therapeutically on the infection. The most data on a favourable effect on infection concern fluvoxamine, a selective serotonin reuptake inhibitor (SSRI), while other antidepressant drugs can diminish the risk of intubation or death. SSRI drugs act therapeutically in post-covid depression. Antiviral effects of chlorpromazine and haloperidol were not confirmed in clinical observations. The use of long-acting injectable atypical antipsychotic drugs may decrease the risk of infection. Despite the evidence of antiviral action of lithium – against herpes in clinical studies and against coronaviruses in experimental papers, the current data on the effect of lithium on the occurrence and course of COVID-19 infection do not allow firm conclusions. Also, the data on the use of valproate is equivocal despite propitious theoretical premises. In the article, the potential of other drugs used in psychiatric therapeutics such as amantadine, disulfiram, hydroxyzine, cannabidiol, melatonin, and memantine was discussed.

Conclusions. Drugs acting therapeutically on the course of COVID-19 may include fluvoxamine and other antidepressants. A favourable effect of lithium on the occurrence and course of COVID-19 infection has not been unambiguously demonstrated despite previous numerous data on the drug’s antiviral activity.

Address for correspondence:
Professor Janusz Rybakowski
Poznan University of Medical Sciences
Department of Adult Psychiatry
27/33 Szpitalna Str., 60–572 Poznań, Poland
email: janusz.rybakowski@gmail.com