Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Jan:66:30-44.
doi: 10.1016/j.euroneuro.2022.10.004. Epub 2022 Oct 20.

Psychotropic drug repurposing for COVID-19: A Systematic Review and Meta-Analysis

Giovanna Fico  1 , Ulker Isayeva  2 , Michele De Prisco  3 , Vincenzo Oliva  4 , Brisa Solè  1 , Laura Montejo  1 , Iria Grande  1 , Nestor Arbelo  5 , Marta Gomez-Ramiro  6 , Luis Pintor  7 , Bernardo Carpiniello  2 , Mirko Manchia  8 , Eduard Vieta  9 , Andrea Murru  1
Affiliations
Meta-Analysis

Psychotropic drug repurposing for COVID-19: A Systematic Review and Meta-Analysis

Giovanna Fico et al. Eur Neuropsychopharmacol. 2023 Jan.

Abstract

Several psychotropic drugs, including antidepressants (AD), mood stabilizers, and antipsychotics (AP) have been suggested to have favorable effects in the treatment of COVID-19. The aim of this systematic review and meta-analysis was to collect evidence from studies concerning the scientific evidence for the repurposing of psychotropic drugs in COVID-19 treatment. Two independent authors searched PubMed-MEDLINE, Scopus, PsycINFO, and ClinicalTrials.gov databases, and reviewed the reference lists of articles for eligible articles published up to 13th December 2021. All computational, preclinical and clinical (observational and/or RCTs) studies on the effect of any psychotropic drug on Sars-CoV-2 or patients with COVID-19 were considered for inclusion. We conducted random effect meta-analyses on clinical studies reporting the effect of AD or AP on COVID-19 outcomes. 29 studies were included in the synthesis: 15 clinical, 9 preclinical, and 5 computational studies. 9 clinical studies could be included in the quantitative analyses. AD did not increase the risk of severe COVID-19 (RR= 1.71; CI 0.65-4.51) or mortality (RR=0.94; CI 0.81-1.09). Fluvoxamine was associated with a reduced risk of mortality for COVID-19 (OR=0.15; CI 0.02-0.95). AP increased the risk of severe COVID-19 (RR=3.66; CI 2.76-4.85) and mortality (OR=1.53; CI 1.15-2.03). Fluvoxamine might be a possible candidate for psychotropic drug repurposing in COVID-19 due to its anti-inflammatory and antiviral potential, while evidence on other AD is still controversial. Although AP are associated with worse COVID-19 outcomes, their use should be evaluated case to case and ongoing treatment with antipsychotics should be not discontinued in psychiatric patients.

Keywords: Anti-inflammatory; Antidepressants; Antipsychotics; Antiviral; Covid-19; Psychotropic drugs.

PubMed Disclaimer

Conflict of interest statement

Conflict of interests GF has received CME-related honoraria, or consulting fees from Angelini, Janssen-Cilag and Lundbeck. MSV has received financial support for CME activities or travel funds from Janssen-Cilag and Lundbeck, and has served as a speaker for Casen Recordati. She reports no financial or other relationship relevant to the subject of this article. IG has received grants and served as consultant, advisor or CME speaker for the following identities: Angelini, Casen Recordati, Ferrer, Janssen Cilag, and Lundbeck, Lundbeck-Otsuka, Luye, SEI Healthcare outside the submitted work. MGR has received funding unrelated to the present work for research projects and/or honoraria as a consultant or speaker from the following entities: Angelini, Janssen, Lundbeck, Otsuka, Sanofi-Aventis and Spanish Ministry of Science and Innovation- Instituto de Salud Carlos III. EV has received grants and served as consultant, advisor, or CME speaker for the following entities: AB-Biotics, AbbVie, Angelini, Biogen, Boehringer-Ingelheim, Celon, Dainippon Sumitomo Pharma, Ferrer, Gedeon Richter, GH Research, Glaxo-Smith Kline, Janssen, Lundbeck, Novartis, Organon, Otsuka, Sanofi-Aventis, Sunovion, and Takeda, outside the submitted work.

Figures

Fig 1
Fig. 1
Flow diagram of systematic review selection criteria.
Fig 2
Fig. 2
Meta-analysis of the association between antidepressant use and severe COVID-19. Risk of severe COVID-19 is expressed as risk ratio (RR), adjusted. The diamond represents the pooled RR for the association of AD and severe COVID-19 and the corresponding 95% CI.
Fig 3
Fig. 3
Meta-analysis of the association between antipsychotic use and severe COVID-19. Risk of severe COVID-19 is expressed as risk ratio (RR), unadjusted. The diamond represents the pooled RR and corresponding 95% CI.
Fig 4
Fig. 4
Meta-analysis of the association between treatment with fluvoxamine and mortality in patients with COVID-19. COVID-19 mortality is expressed as Odds Ratio (OR). The diamond represents the pooled OR and corresponding 95% CI.
Fig 5
Fig. 5
Meta-analysis of the association between treatment with antidepressants and mortality in patients with COVID-19. COVID-19 mortality is expressed as Risk Ratio (RR), adjusted. The diamond represents the pooled RR and corresponding 95% CI.
Fig 6
Fig. 6
Meta-analysis of the association between treatment with antipsychotics and mortality in patients with COVID-19. COVID-19 mortality is expressed as Odds Ratio (OR), unadjusted. The diamond represents the pooled OR and corresponding 95% CI.
See this image and copyright information in PMC

References

    1. AHRQ Comparative Effectiveness Reviews - NCBI Bookshelf [WWW Document], n.d. URL https://www.ncbi.nlm.nih.gov/books/NBK42934/(accessed 12.17.21).
    1. Anmella G., Arbelo N., Fico G., Murru A., Llach C.D., Madero S., Gomes-da-Costa S., Imaz M.L., López-Pelayo H., Vieta E., Pintor L. COVID-19 inpatients with psychiatric disorders: real-world clinical recommendations from an expert team in consultation-liaison psychiatry. J. Affect. Disord. 2020;274:1062–1067. doi: 10.1016/J.JAD.2020.05.149. - DOI - PMC - PubMed
    1. Attademo L., Bernardini F. Are dopamine and serotonin involved in COVID-19 pathophysiology? Eur. J. Psychiatry. 2021;35:62. doi: 10.1016/J.EJPSY.2020.10.004. - DOI - PMC - PubMed
    1. Baumeister D., Ciufolini S., Mondelli V. Effects of psychotropic drugs on inflammation: consequence or mediator of therapeutic effects in psychiatric treatment? Psychopharmacology. 2016;233:1575–1589. doi: 10.1007/S00213-015-4044-5. - DOI - PubMed
    1. Beigel J.H., Tomashek K.M., Dodd L.E., Mehta A.K., Zingman B.S., Kalil A.C., Hohmann E., Chu H.Y., Luetkemeyer A., Kline S., Lopez de Castilla D., Finberg R.W., Dierberg K., Tapson V., Hsieh L., Patterson T.F., Paredes R., Sweeney D.A., Short W.R., Touloumi G., Lye D.C., Ohmagari N., Oh M., Ruiz-Palacios G.M., Benfield T., Fätkenheuer G., Kortepeter M.G., Atmar R.L., Creech C.B., Lundgren J., Babiker A.G., Pett S., Neaton J.D., Burgess T.H., Bonnett T., Green M., Makowski M., Osinusi A., Nayak S., Lane H.C. Remdesivir for the treatment of Covid-19 — final report. N. Engl. J. Med. 2020;383:1813–1826. doi: 10.1056/NEJMoa2007764. - DOI - PMC - PubMed

Publication types