Journal
EUROPEAN NEUROPSYCHOPHARMACOLOGY
Volume 66, Issue -, Pages 30-44Publisher
ELSEVIER
DOI: 10.1016/j.euroneuro.2022.10.004
Keywords
Covid-19; Psychotropic drugs; Antidepressants; Antipsychotics; Anti-inflammatory; Antiviral
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This systematic review and meta-analysis investigates the repurposing of psychotropic drugs in the treatment of COVID-19. The study finds that antidepressants do not significantly affect the risk and mortality of COVID-19, while fluvoxamine may have potential in reducing mortality risk. Antipsychotics may increase the risk of severe COVID-19 and mortality, but their use in psychiatric patients should be evaluated on a case-by-case basis.
Several psychotropic drugs, including antidepressants (AD), mood stabilizers, and antipsy-chotics (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 treat-ment. Two independent authors searched PubMed-MEDLINE, Scopus, PsycINFO, and ClinicalTri-als.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 synthe-sis: 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 asso-ciated 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. (c) 2022 Elsevier B.V. and ECNP. All rights reserved.
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