Établissement public de santé Alsace Nord, 141, avenue Strasbourg, 67170 Brumath, France; Laboratoire de toxicologie et pharmacologie neuro cardiovasculaire, centre de recherche en biomédecine de Strasbourg, université de Strasbourg, 1, rue Eugène-Boeckel, 67000 Strasbourg, France.
Département de pharmacie, CHU d'Henri-Mondor, université Paris Est Créteil (UPEC), AP-HP, 1, rue Gustave-Eiffel, 94000 Créteil, France; Inserm U955, institut Mondor de recherche biomédical, neuropsychiatrie translationnelle, 8, rue du Général-Sarrail, 94000 Créteil, France.
Encephale. 2021 Dec;47(6):564-588. doi: 10.1016/j.encep.2021.08.002. Epub 2021 Sep 2.
The use of psychotropics during the COVID-19 pandemic has raised two questions, in order of importance: first, what changes should be made to pharmacological treatments prescribed to mental health patients? Secondly, are there any positive side effects of these substances against SARS-CoV-2? Our aim was to analyze usage safety of psychotropics during COVID-19; therefore, herein, we have studied: (i) the risk of symptomatic complications of COVID-19 associated with the use of these drugs, notably central nervous system activity depression, QTc interval enlargement and infectious and thromboembolic complications; (ii) the risk of mistaking the iatrogenic impact of psychotropics with COVID-19 symptoms, causing diagnostic error. Moreover, we provided a summary of the different information available today for these risks, categorized by mental health disorder, for the following: schizophrenia, bipolar disorder, anxiety disorder, ADHD, sleep disorders and suicidal risk. The matter of psychoactive substance use during the pandemic is also analyzed in this paper, and guideline websites and publications for psychotropic treatments in the context of COVID-19 are referenced during the text, so that changes on those guidelines and eventual interaction between psychotropics and COVID-19 treatment medication can be reported and studied. Finally, we also provide a literature review of the latest known antiviral properties of psychotropics against SARS-CoV-2 as complementary information.
在 COVID-19 大流行期间使用精神药物引发了两个问题,按重要性顺序排列:首先,应针对精神健康患者开出的药物治疗方案做出哪些改变?其次,这些物质对 SARS-CoV-2 是否有任何积极的副作用?我们的目的是分析 COVID-19 期间精神药物的使用安全性;因此,在此,我们研究了:(i)使用这些药物与 COVID-19 相关的症状性并发症的风险,尤其是中枢神经系统活动抑制、QTc 间期延长以及感染和血栓栓塞并发症;(ii)将精神药物的医源性影响误诊为 COVID-19 症状,从而导致诊断错误的风险。此外,我们还根据以下精神障碍类别,对这些风险的不同信息进行了总结:精神分裂症、双相情感障碍、焦虑症、ADHD、睡眠障碍和自杀风险。本文还分析了大流行期间使用精神活性物质的问题,并在文中引用了精神药物治疗 COVID-19 的指南网站和出版物,以便报告和研究这些指南的变化以及精神药物与 COVID-19 治疗药物之间的相互作用。最后,我们还提供了精神药物针对 SARS-CoV-2 的最新抗病毒特性的文献综述,作为补充信息。