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Review
. 2020 Jun 22:10:2045125320935306.
doi: 10.1177/2045125320935306. eCollection 2020.

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

Delia Bishara  1 , Chris Kalafatis  2 , David Taylor  2
Affiliations
Review

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

Delia Bishara et al. Ther Adv Psychopharmacol. .

Abstract

As yet, no agents have been approved for the treatment of COVID-19, although several experimental drugs are being used off licence. These may have serious adverse effects and potential drug interactions with psychotropic agents. We reviewed the common agents being used across the world for the treatment of COVID-19 and investigated their drug interaction potential with psychotropic agents using several drug interaction databases and resources. A preliminary search identified the following drugs as being used to treat COVID-19 symptoms: atazanavir (ATV), azithromycin (AZI), chloroquine (CLQ)/hydroxychloroquine (HCLQ), dipyridamole, famotidine (FAM), favipiravir, lopinavir/ritonavir (LPV/r), nitazoxanide, remdesivir, ribavirin and tocilizumab. Many serious adverse effects and potential drug interactions with psychotropic agents were identified. The most problematic agents were found to be ATV, AZI, CLQ, HCLQ, FAM and LPV/r in terms of both pharmacokinetic as well as serious pharmacodynamic drug interactions, including QTc prolongation and neutropenia. Significant caution should be exercised if using any of the medications being trialled for the treatment of COVID-19 until robust clinical trial data are available. An even higher threshold of vigilance should be maintained for patients with pre-existing conditions and older adults due to added toxicity and drug interactions, especially with psychotropic agents.

Keywords: adverse effects; drug-interactions; psychotropic drugs; treatment COVID-19.

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Conflict of interest statement

Conflict of interest statement: The authors declare that there is no conflict of interest.

References

    1. Kalil AC. Treating COVID-19-off-label drug use, compassionate use, and randomized clinical trials during pandemics. JAMA. Epub ahead of print 24 March 2020. DOI: 10.1001/jama.2020.4742. - DOI - PubMed
    1. Sayburn A. Covid-19: trials of four potential treatments to generate “robust data” of what works. BMJ 2020; 368: m1206. - PubMed
    1. Recovery: Randomised Evaluation of COVID-19 Therapy. This nation clinical trials aims to identify treatments that may be beneficial for adults hospitalised with confirmed COVID-19, https://www.recoverytrial.net/ (accessed 27 March 2020).
    1. Medicines Complete. Stockley’s interactions checker, https://about.medicinescomplete.com/publication/stockleys-interactions-c... (accessed 06 May 2020).
    1. HIV Drug Interactions. Interaction checker. University of Liverpool, www.hiv-druginteractions.org (accessed 06 May 2020).