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Drug-drug interactions between COVID-19 treatments and antipsychotics drugs: integrated evidence from 4 databases and a systematic review.

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Title: Drug-drug interactions between COVID-19 treatments and antipsychotics drugs: integrated evidence from 4 databases and a systematic review.
Authors: Plasencia-García, Beatriz Oda (AUTHOR), Rodríguez-Menéndez, Gonzalo (AUTHOR), Rico-Rangel, María Isabel (AUTHOR), Rubio-García, Ana (AUTHOR), Torelló-Iserte, Jaime (AUTHOR), Crespo-Facorro, Benedicto (AUTHOR)
Source: Psychopharmacology. 2021, Vol. 238 Issue 2, p329-340. 12p. 4 Charts.
Subjects: COVID-19 treatment, Ritonavir, COVID-19, Antipsychotic agents, Aripiprazole, Drug interactions
Geographic Terms: Liverpool (England)
Abstract: Rationale: Management of anxiety, delirium, and agitation cannot be neglected in coronavirus disease (COVID-19). Antipsychotics are usually used for the pharmacological management of delirium, and confusion and behavioral disturbances. The concurrent use of treatments for COVID-19 and antipsychotics should consider eventual drug-drug interactions Objective: To systematically review evidence-based available on drug-drug interactions between COVID-19 treatments and antipsychotics. Evidence review: Three databases were consulted: Lexicomp® Drug Interactions, Micromedex® Solutions Drugs Interactions, and Liverpool© Drug Interaction Group for COVID-19 therapies. To acquire more information on QT prolongation and Torsade de Pointes (TdP), the CredibleMeds® QTDrugs List was searched. The authors made a recommendation agreed to by consensus. Additionally, a systematic review of drug-drug interactions between antipsychotics and COVID-19 treatment was conducted. Results: The main interactions between COVID-19 drugs and antipsychotics are the risk of QT-prolongation and TdP, and cytochromes P450 interactions. Remdesivir, baricinitib, and anakinra can be used concomitantly with antipsychotics without risk of drug-drug interaction (except for hematological risk with clozapine and baricinitib). Favipiravir only needs caution with chlorpromazine and quetiapine. Tocilizumab is rather safe to use in combination with antipsychotics. The most demanding COVID-19 treatments for coadministration with antipsychotics are chloroquine, hydroxychloroquine, azithromycin, and lopinavir/ritonavir because of the risk of QT prolongation and TdP and cytochromes interactions. The systematic review provides highly probable drug interaction between lopinavir/ritonavir plus quetiapine and ritonavir/indinavir plus risperidone. Conclusions: Clinicians prescribing antipsychotics should be aware of the likely risk of drug-drug interaction with COVID-19 medication and may benefit from taking into account present recommendations of use to preserve patient safety [ABSTRACT FROM AUTHOR]
Copyright of Psychopharmacology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Drug-drug interactions between COVID-19 treatments and antipsychotics drugs: integrated evidence from 4 databases and a systematic review.
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  Data: <searchLink fieldCode="AR" term="%22Plasencia-García%2C+Beatriz+Oda%22">Plasencia-García, Beatriz Oda</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rodríguez-Menéndez%2C+Gonzalo%22">Rodríguez-Menéndez, Gonzalo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rico-Rangel%2C+María+Isabel%22">Rico-Rangel, María Isabel</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rubio-García%2C+Ana%22">Rubio-García, Ana</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Torelló-Iserte%2C+Jaime%22">Torelló-Iserte, Jaime</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Crespo-Facorro%2C+Benedicto%22">Crespo-Facorro, Benedicto</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Psychopharmacology%22">Psychopharmacology</searchLink>. 2021, Vol. 238 Issue 2, p329-340. 12p. 4 Charts.
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  Data: <searchLink fieldCode="DE" term="%22COVID-19+treatment%22">COVID-19 treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Ritonavir%22">Ritonavir</searchLink><br /><searchLink fieldCode="DE" term="%22COVID-19%22">COVID-19</searchLink><br /><searchLink fieldCode="DE" term="%22Antipsychotic+agents%22">Antipsychotic agents</searchLink><br /><searchLink fieldCode="DE" term="%22Aripiprazole%22">Aripiprazole</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+interactions%22">Drug interactions</searchLink>
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  Data: Rationale: Management of anxiety, delirium, and agitation cannot be neglected in coronavirus disease (COVID-19). Antipsychotics are usually used for the pharmacological management of delirium, and confusion and behavioral disturbances. The concurrent use of treatments for COVID-19 and antipsychotics should consider eventual drug-drug interactions Objective: To systematically review evidence-based available on drug-drug interactions between COVID-19 treatments and antipsychotics. Evidence review: Three databases were consulted: Lexicomp® Drug Interactions, Micromedex® Solutions Drugs Interactions, and Liverpool© Drug Interaction Group for COVID-19 therapies. To acquire more information on QT prolongation and Torsade de Pointes (TdP), the CredibleMeds® QTDrugs List was searched. The authors made a recommendation agreed to by consensus. Additionally, a systematic review of drug-drug interactions between antipsychotics and COVID-19 treatment was conducted. Results: The main interactions between COVID-19 drugs and antipsychotics are the risk of QT-prolongation and TdP, and cytochromes P450 interactions. Remdesivir, baricinitib, and anakinra can be used concomitantly with antipsychotics without risk of drug-drug interaction (except for hematological risk with clozapine and baricinitib). Favipiravir only needs caution with chlorpromazine and quetiapine. Tocilizumab is rather safe to use in combination with antipsychotics. The most demanding COVID-19 treatments for coadministration with antipsychotics are chloroquine, hydroxychloroquine, azithromycin, and lopinavir/ritonavir because of the risk of QT prolongation and TdP and cytochromes interactions. The systematic review provides highly probable drug interaction between lopinavir/ritonavir plus quetiapine and ritonavir/indinavir plus risperidone. Conclusions: Clinicians prescribing antipsychotics should be aware of the likely risk of drug-drug interaction with COVID-19 medication and may benefit from taking into account present recommendations of use to preserve patient safety [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Psychopharmacology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1007/s00213-020-05716-4
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              Text: 2021
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