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

Giovanni Ostuzzi, Davide Papola, Chiara Gastaldon, Georgios Schoretsanitis, Federico Bertolini, Francesco Amaddeo, Alessandro Cuomo, Robin Emsley, Andrea Fagiolini, Giuseppe Imperadore, Taishiro Kishimoto, Giulia Michencigh, Michela Nosé, Marianna Purgato, Dursun Serdar, Brendon Stubbs, David Taylor, Graham Thornicroft, Philip B. Ward, Christoph HiemkeChristoph U. Correll, Corrado Barbui

Research output: Contribution to journalReview article

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.

Original languageEnglish
Number of pages1
JournalBMC Medicine
Volume18
Issue number1
DOIs
Publication statusPublished - 2020 Jul 15

Keywords

  • COVID-19
  • Drug–drug interactions
  • Novel coronavirus
  • Psychiatric comorbidity
  • Psychopharmacology

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'Safety of psychotropic medications in people with COVID-19: evidence review and practical recommendations'. Together they form a unique fingerprint.

  • Cite this

    Ostuzzi, G., Papola, D., Gastaldon, C., Schoretsanitis, G., Bertolini, F., Amaddeo, F., Cuomo, A., Emsley, R., Fagiolini, A., Imperadore, G., Kishimoto, T., Michencigh, G., Nosé, M., Purgato, M., Serdar, D., Stubbs, B., Taylor, D., Thornicroft, G., Ward, P. B., ... Barbui, C. (2020). Safety of psychotropic medications in people with COVID-19: evidence review and practical recommendations. BMC Medicine, 18(1). https://doi.org/10.1186/s12916-020-01685-9