Practical prescribing with COVID-19 medications and psychotropics: a guide to pharmacokinetic interactions

Alessandro Cuomo, Giovanni Barillà, Bruno Beccarini Crescenzi, Simone Bolognesi, Maria Nitti, Andrea Fagiolini

Department of Molecular Medicine, University of Siena School of Medicine, Siena, Italy

Background 

The risks of pharmacological interactions increase significantly with the number of drugs a patient is prescribed. Patients with coronavirus (COVID-19) infection and mental disorders often receive several medications, and they may interact. 

Methods 

We examined the existing literature with the goal to: 1) review the bases of pharmacokinetic interactions between psychotropics and medications that are prescribed to treat COVID-19 infection and its complications; 2) examine the implications for clinical practice.

Results 

Pharmacokinetic interactions are possible and may cause adverse effects or decrease the efficacy of one or more of the medications a patient is taking. 

Conclusions 

A thorough evaluation of the pharmacokinetic interactions is necessary when COVID-19 medications are prescribed to patients with mental disorders that are treated with psychotropic medications. The risk of pharmacokinetic and pharmacodynamic interactions should inform treatment choice and may require dosing adjustments.

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