Drug-Drug Interactions Between COVID-19 Treatments and Psychotropic Medications: An Updated Study

Ujwal Boppana; Thomas S Leonard; Ayodeji Jolayemi; Maliha I Ansari; Andrew Salib

doi:10.7759/cureus.50469

Drug-Drug Interactions Between COVID-19 Treatments and Psychotropic Medications: An Updated Study

Cureus. 2023 Dec 13;15(12):e50469. doi: 10.7759/cureus.50469. eCollection 2023 Dec.

Authors

Ujwal Boppana¹, Thomas S Leonard¹, Ayodeji Jolayemi¹, Maliha I Ansari², Andrew Salib^{3

4}

Affiliations

¹ Psychiatry, Interfaith Medical Center, Brooklyn, USA.
² College of Medicine, Pramukhswami Medical College, Anand, IND.
³ College of Medicine, Florida International University, Herbert Wertheim College of Medicine, Florida, USA.
⁴ College of Medicine, American University of Antigua College of Medicine, St. John's, ATG.

Abstract

The recent evolution of coronavirus disease 2019 (COVID-19) treatments has created challenges for healthcare providers in terms of new potential interactions between these COVID-19 treatments and psychotropic drugs in patients with psychiatric disorders. Current clinical practice guidelines on managing interactions between psychotropic medications and COVID-19 treatments do not account for the newer COVID-19 medications. There is a need for updated patient management recommendations that take into account drug interactions between psychotropic drugs and the latest pharmacological approaches to COVID-19 treatment. A search of literature pertaining to drug interactions and outcomes in patients concurrently prescribed COVID-19 treatments and psychotropic medications was conducted. Drug databases were also analyzed to screen for interactions. Our review focuses on the most recent and effective COVID-19 treatments, including Paxlovid^TM (nirmatrelvir/ritonavir), remdesivir, dexamethasone, tocilizumab, and baricitinib. The study provides condensed and easily interpretable tables for healthcare providers to screen for potentially harmful drug interactions. We discuss the implications of our findings on appropriate treatment plan selection by healthcare providers for patients taking select antipsychotics, antidepressants, mood stabilizers, and benzodiazepines while receiving COVID-19 treatments. Notably, Paxlovid^TMmay interact with several medications, particularly antipsychotics and anxiolytics, necessitating close monitoring and, in some cases, reconsideration of use. We find that dexamethasone, remdesivir, tocilizumab, and baricitinib have fewer reported interactions with psychotropics, and while some monitoring is necessary, no major adjustments are recommended for their administration in conjunction with psychotropic medications. These findings underscore the importance of careful consideration and monitoring when combining COVID-19 treatments with other medications to mitigate the risk of adverse interactions and ensure patient safety.

Keywords: antidepressants; antipsychotics; benzodiazepines; covid 19; drug-drug interactions; medication therapy management; mood stabilizers; psychotropic.

Publication types

Review