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Pharmacopsychiatry 2021; 54(03): 142-143
DOI: 10.1055/a-1408-8298
Letter to the Editor

Are Persons Treated with Antidepressants and/or Antipsychotics Possibly Better Protected against Severe COVID 19?

Udo Bonnet
1   Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Academic Teaching Hospital of the University of Duisburg-Essen, Essen, Germany
2   LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Duisburg-Essen, Essen, Germany
,
Georg Juckel
3   Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
,
Norbert Scherbaum
2   LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Duisburg-Essen, Essen, Germany
,
Martin Schaefer
4   Department of Psychiatry, Psychotherapy, Psychosomatics and Addiction Medicine, Evang. Kliniken Essen-Mitte, Essen, Germany
5   Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Germany
,
Bernhard Kis
6   Department of Psychiatry, Psychotherapy and Psychosomatics, St. Elisabeth Hospital Niederwenigern, Contilia Group, Hattingen, Germany
7   Department of Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany
,
Simon Cohen
8   Klinik für Psychiatrie, Psychotherapie und Gerontopsychiatrie, HELIOS Marien Klinik, Duisburg, Germany
,
Jens Kuhn
9   Department of Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany
10   Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Johanniter Hospital Oberhausen, Oberhausen, Germany
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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.

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