Subscribe to RSS
DOI: 10.1055/a-1408-8298
Are Persons Treated with Antidepressants and/or Antipsychotics Possibly Better Protected against Severe COVID 19?
Dear Editor,
The Corona Disease 2019 (COVID 19), manifesting as a rule as an acute and potentially critical respiratory syndrome related to the SARS-Cov-2 virus infection, has been running up to a global health emergency. Some patients infected by SARS-Cov-2 develop an unfavored clinical course mostly in the second week after infection. This “delayed course” can culminate to a critical illness and is deemed to be related to a hyperinflammatory response to the virus, which is called “cytokine-storm” and includes a substantial increase in the systemic activity of pro-inflammatory cytokines [1] [2]. Dependent on the individual cellular resilience, this hyperinflammatory cytokine-attack can lead to organ or multi-organ damage resulting at least partly from excessive oxidative stress [1] [2].
At this juncture, dexamethasone and specific inhibitors of pro-inflammatory cytokine-pathways have been taken into consideration to combat severe COVID-19 [1] [2]. However, also antidepressants should be kept in mind as this substance class itself is well known to decrease pro-inflammatory cytokine-levels, particularly TNF-α, IL-1β and IL6 [3], all of which are involved in the SARS-Cov-2-induced hyperinflammatory response [1] [2]. Thus, the question arises whether ADs, or probably also antipsychotics, and mood stabilizers (including lithium), which also have been supposed to reduce the production of pro-inflammatory cytokines to some extent [4] [5], might be protective against the development of unfavored/critical COVID-19 courses.
Publication History
Received: 03 February 2021
Received: 05 February 2021
Accepted: 02 March 2021
Article published online:
17 March 2021
© 2021. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Feldt T, Karagiannidis C, Mager S. et al. Welche Rolle spielt ein mögliches Hyperinflammationssyndrom bei einer schweren COVID-19-Infektion und können hieraus Konsequenzen für die Therapie gezogen werden?. Erfahrungen im Umgang mit COVID-19-Erkrankten – Hinweise von Klinikern für Kliniker. DOI: 10.25646/7037 Stand: 27.07.2020
- 2 Chugh H, Awasthi A, Agarwal Y. et al. comprehensive review on potential therapeutics interventions for COVID-19. Eur J Pharmacol 2021; 890: 173741 DOI: 10.1016/j.ejphar.2020.173741.
- 3 Eyre HA, Lavretsky H, Kartika J. et al. Modulatory effects of antidepressant classes on the innate and adaptive immune system in depression. Pharmacopsychiatry 2016; 49: 85-96 DOI: 10.1055/s-0042-103159.
- 4 Dinesh AA, Islam J, Khan J. et al. Effects of antipsychotic drugs: Cross talk between the nervous and innate immune system. CNS Drugs 2020; 34: 1229-1251 DOI: 10.1007/s40263-020-00765-x.
- 5 Himmerich H, Bartsch S, Hamer H. et al. Impact of mood stabilizers and antiepileptic drugs on cytokine production in-vitro. J Psychiatr Res 2013; 47: 1751-1759 DOI: 10.1016/j.jpsychires.2013.07.026.
- 6 Lenze EJ, Mattar C, Zorumski CF. et al. Fluvoxamine vs. Placebo and Clinical Deterioration in Outpatients With Symptomatic COVID-19: A Randomized Clinical Trial. JAMA 2020; 324: 2292-2300 DOI: 10.1001/jama.2020.22760.
- 7 Schloer S, Brunotte L, Goretzko J. et al. Targeting the endolysosomal host-SARS-CoV-2 interface by clinically licensed functional inhibitors of acid sphingomyelinase (FIASMA) including the antidepressant fluoxetine. Emerg Microbes Infect 2020; 9: 2245-2255 DOI: 10.1080/22221751.2020.1829082.
- 8 Bonnet U. How much alcohol is in ketamine’s antidepressant action?. Life Sci 2017; 168: 54-57 DOI: 10.1016/j.lfs.2016.11.003.
- 9 Nemani K, Li C, Olfson M. et al. Association of Psychiatric Disorders With Mortality Among Patients With COVID-19. JAMA Psychiatry. 2021 [Epub ahead of print] DOI: 10.1001/jamapsychiatry.2020.4442
- 10 Wang Q, Xu R, Volkow ND. Increased risk of COVID-19 infection and mortality in people with mental disorders: Analysis from electronic health records in the United States. World Psychiatry 2021; 20: 124-130 DOI: 10.1002/wps.20806.
- 11 Xiong GL, Atkin A, Moquin K. et al. COVID-19 transmission in a psychiatric long-term care rehabilitation facility: an observational study. Prim Care Companion CNS Disord 2020; 22: 20m02765 DOI: 10.4088/PCC.20m02765.