Adverse drug reaction associated with COVID-19 management in patients receiving psychotropic medications
Keywords:
adverse drug reaction, COVID-19, COVID-19 medication, drug interaction, psychotropic medicationAbstract
Objective: To study the adverse drug reactions in patients treated with psychotropic and COVID-19 medications.
Methods: A retrospective observational study was conducted among patients receiving psychotropic and COVID-19 medications in Nakhon Sawan Rajanagarinda Psychiatric Hospital. Electronic medical records from July to August 2021 were reviewed to assess drug prescription patterns, laboratory tests, and the occurrence of adverse drug reactions. Causative drugs and drug interactions were identified by using Naranjo’s algorithm. Relationships between adverse drug reactions and medications were assessed by using Fisher’s exact test.
Results: The participants (n = 23) were all male with a mean of age 33.39 ± 8.23 years. Most were diagnosed with schizophrenia (78.3%) and had mild COVID-19 illness (65.2%). The most common COVID-19 prescription was favipiravir (3,600 mg/day on day 1 followed by 1,600 mg/day on days 2 - 10) in combination with lopinavir/ritonavir and dexamethasone. Adverse drug reactions were identified, including two occurrences of tremor and one occurrence of hyperglycemia, fatigue, dystonia, tachycardia, and diarrhea. Hepatic enzymes (AST and ALT) were found to elevate approximately two folds of the baseline in those receiving favipiravir + lopinavir/ritonavir + dexamethasone. Significant association between dexamethasone and hyperglycemia (p = .043) and trend of association between lopinavir/ritonavir + haloperidol and tremor (p = .087) were found.
Conclusion: Although adverse drug reactions in patients treating with COVID-19 and psychotropic medications are not frequent and mostly non-serious, such patients should receive monitoring for these reactions, particularly extrapyramidal symptoms, and laboratory tests.
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