Remdesivir & Psychotropics Interactions

On Oct 22, 2020: FDA approved the antiviral medication Remdesivir for the treatment of COVID-19 requiring hospitalization. This was the first treatment for COVID-19 to receive FDA approval.

We will discuss the risk of drug interactions between Remdesivir and psychotropic medications in the following sections:

  1. Antidepressants
  2. Antipsychotics
  3. Mood Stabilizers
  4. Benzodiazepines

REFERENCES:

  • FDA NEWS RELEASE: FDA Approves First Treatment for COVID-19 (PDF)
  • Ostuzzi G et al. Safety of psychotropic medications in people with COVID-19: evidence review and practical recommendations. BMC Med. 2020 Jul 15;18(1):215. Erratum in: BMC Med. 2020 Sep 12;18(1):291. PMID: 32664944; PMCID: PMC7360478.
  • Remdesivir and Potential Interactions With Psychotropic Medications: A COVID-19 Perspective. Prim Care Companion CNS Disord. 2020 May 28;22(3):20com02664. PMID: 32470232.
  • Bilbul M, Paparone P, Kim AM, Mutalik S, Ernst CL. Psychopharmacology of COVID-19. Psychosomatics. 2020 Sep-Oct;61(5):411-427. PMID: 32425246; PMCID: PMC7232075.
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BEING COVID READY IN PSYCHIATRIC PRACTICE

This educational activity is dedicated to the essential and must-know clinical facts regarding the interaction of COVID-19 and Psychiatry.

This educational series will be discussed in the following five sections:

(1) PULMONARY: COVID-19 & Psychiatry:

  • Antipsychotics: Cautions, Risk Factors; Preferred antipsychotics and High-Risk antipsychotics.
  • Antidepressants: Cautions, Risk Factors; At-Risk antidepressants.
  • Mood Stabilizers: Preferred and At-Risk mood stabilizers (individual and combinations)
  • Benzodiazepines: Risk Factors; Preferred benzodiazepine.

(2) CARDIAC: COVID-19 & Psychiatry:

  • Antipsychotics: High-Risk, Moderate-Risk and Low-Risk antipsychotics.
  • Antidepressants: High-Risk, Moderate-Risk and Low-Risk antidepressants.
  • Mood Stabilizers: Preferred mood stabilizer.
  • Management of psychosis and agitation in medical-surgical patients who have or are at risk for prolonged QT interval.

(3) HEMATOLOGIC: COVID-19 & Psychiatry:

  • Antidepressants: of choice with Bleeding risk, Thromboembolism and Neutropenia.
  • Antipsychotics: risk of Neutropenia.
  • Mood Stabilizers: risk of Neutropenia.

(4) DRUG-DRUG INTERACTIONS: COVID-19 Medications & Psychotropics:

High-Risk, Moderate-Risk and Low-Risk Antipsychotics, Antidepressants, Mood Stabilizers and Benzodiazepines with:

  • Hydroxychloroquine
  • Remdesivir
  • Lopinavir / Ritonavir
  • Azithromycin

(5) PSYCHOTROPICS MONITORING: During COVID-19:

(a) Lithium:

  • Lithium monitoring during COVID-19: for normal and at-risk patients.

(b) Clozapine:

  • ANC monitoring during COVID-19.
  • When to reduce the frequency of ANC monitoring?
  • If patient develops an infection on clozapine.
  • Monitoring protocol if clozapine toxicity develops.

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JOIN PSYCHIATRY EDUCATION FORUM ACADEMY MEMBERSHIP

This is a closed membership for medical professionals only.

  • 30+ Courses/Sections: Each chapter within these sections is of direct clinical relevance for your daily practice. 
  • Journal Club: we will post the most recently published psychiatry articles relevant to your daily clinical practice.
  • Coffee Club: contain short discussions with clinical experts in the field of psychiatry.
  • Essentials of Inpatient Psychiatry Book: All chapters from this book are included in the academy sections. 
  • Discussion Forum & Community: Connect with other medical professionals and discuss your difficult-to-treat clinical cases.
  • Conference Discounts: Academy members get discounted access at our conferences. 
  • Goal: is to have all important clinically relevant topics in one place for ease of access.
 

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REFERENCES:

  • FDA NEWS RELEASE: FDA Approves First Treatment for COVID-19 (PDF)
  • Ostuzzi G et al. Safety of psychotropic medications in people with COVID-19: evidence review and practical recommendations. BMC Med. 2020 Jul 15;18(1):215. Erratum in: BMC Med. 2020 Sep 12;18(1):291. PMID: 32664944; PMCID: PMC7360478.
  • Remdesivir and Potential Interactions With Psychotropic Medications: A COVID-19 Perspective. Prim Care Companion CNS Disord. 2020 May 28;22(3):20com02664. PMID: 32470232.
  • Bilbul M, Paparone P, Kim AM, Mutalik S, Ernst CL. Psychopharmacology of COVID-19. Psychosomatics. 2020 Sep-Oct;61(5):411-427. PMID: 32425246; PMCID: PMC7232075.

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