Adverse drug reactions associated with concurrent acute psychiatric treatment and Covid-19 drug therapy.
Identifieur interne : 001929 ( Main/Exploration ); précédent : 001928; suivant : 001930Adverse drug reactions associated with concurrent acute psychiatric treatment and Covid-19 drug therapy.
Auteurs : Ekin Sönmez Güngör [Turquie] ; Murat Yalç N [Turquie] ; Melike Yerebakan Tüzer [Turquie] ; Didem Be Ikçi Kele [Turquie] ; Tuba Öcek Ba [Turquie] ; Mine Ergelen [Turquie] ; Alper Bülbül [Turquie] ; Betül K R Avo Lu [Turquie] ; Mustafa Güne [Turquie]Source :
- International journal of psychiatry in clinical practice [ 1471-1788 ] ; 2020.
Abstract
OBJECTIVE
Psychiatric patients are at increased risk of contamination, morbidity, and mortality associated with COVID-19, together with potentially more pronounced adverse effects. We present and discuss the adverse effects observed in an acute psychiatric clinic that has admitted COVID-19 patients during the first three months of the pandemic in Turkey.
METHODS
The COVID-19 treatment schemes were formed in accordance with the national and regional guidelines at the time of admittance, which were mainly based on the use of hydroxychloroquine and other drugs. The sample consisted exclusively of inpatients, and all patients were enrolled in the study regardless of their specific diagnosis or treatment schemes.
RESULTS
4 out of 23 patients (17.4%) had experienced adverse effects, two of which had mild hepatic enzyme elevation and one had mild sinus bradycardia. Of note is that we haven't encountered any serious complications or life-threatening events during inpatient treatment. The most emphasised adverse effect in the literature, namely QTc prolongation and ECG changes, were not observed in our sample. The adverse effects were not found to be significantly associated with patient-related factors nor dose of antipsychotic medication.
CONCLUSIONS
From our point of view, non-cardiac adverse effects should not be overlooked while treating comorbid psychiatric and COVID-19 patients.KEY POINTSAcute inpatient psychiatric treatment of patients who have comorbid COVID-19 is a complex situation requiring multidisciplinary action.Adverse drug reactions, which may or not result from the interaction of psychiatric and COVID-19 treatment, should be of concern for this patient group.While there is controversy over the benefits of some of the off-label COVID-19 medications, there should also be discussion over safety and concomitant medication use.In order to be adequately prepared for future escalations of COVID-19 pandemic, psychiatric services should thoroughly evaluate their initial experience with COVID-19, including from the point of drug effectiveness and safety.
DOI: 10.1080/13651501.2020.1843182
PubMed: 33143519
Affiliations:
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Hospital, Istanbul, Turkey.</nlm:affiliation><country xml:lang="fr">Turquie</country><wicri:regionArea>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Be Ikci Kele, Didem" sort="Be Ikci Kele, Didem" uniqKey="Be Ikci Kele D" first="Didem" last="Be Ikçi Kele">Didem Be Ikçi Kele</name><affiliation wicri:level="1"><nlm:affiliation>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul, Turkey.</nlm:affiliation><country xml:lang="fr">Turquie</country><wicri:regionArea>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Ocek Ba, Tuba" sort="Ocek Ba, Tuba" uniqKey="Ocek Ba T" first="Tuba" last="Öcek Ba">Tuba Öcek Ba</name><affiliation wicri:level="1"><nlm:affiliation>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul, Turkey.</nlm:affiliation><country xml:lang="fr">Turquie</country><wicri:regionArea>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Ergelen, Mine" sort="Ergelen, Mine" uniqKey="Ergelen M" first="Mine" last="Ergelen">Mine Ergelen</name><affiliation wicri:level="1"><nlm:affiliation>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul, Turkey.</nlm:affiliation><country xml:lang="fr">Turquie</country><wicri:regionArea>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Bulbul, Alper" sort="Bulbul, Alper" uniqKey="Bulbul A" first="Alper" last="Bülbül">Alper Bülbül</name><affiliation wicri:level="1"><nlm:affiliation>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul, Turkey.</nlm:affiliation><country xml:lang="fr">Turquie</country><wicri:regionArea>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="K R Avo Lu, Betul" sort="K R Avo Lu, Betul" uniqKey="K R Avo Lu B" first="Betül" last="K R Avo Lu">Betül K R Avo Lu</name><affiliation wicri:level="1"><nlm:affiliation>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul, Turkey.</nlm:affiliation><country xml:lang="fr">Turquie</country><wicri:regionArea>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Gune, Mustafa" sort="Gune, Mustafa" uniqKey="Gune M" first="Mustafa" last="Güne">Mustafa Güne</name><affiliation wicri:level="1"><nlm:affiliation>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul, Turkey.</nlm:affiliation><country xml:lang="fr">Turquie</country><wicri:regionArea>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author></analytic><series><title level="j">International journal of psychiatry in clinical practice</title><idno type="eISSN">1471-1788</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>Psychiatric patients are at increased risk of contamination, morbidity, and mortality associated with COVID-19, together with potentially more pronounced adverse effects. We present and discuss the adverse effects observed in an acute psychiatric clinic that has admitted COVID-19 patients during the first three months of the pandemic in Turkey.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>The COVID-19 treatment schemes were formed in accordance with the national and regional guidelines at the time of admittance, which were mainly based on the use of hydroxychloroquine and other drugs. The sample consisted exclusively of inpatients, and all patients were enrolled in the study regardless of their specific diagnosis or treatment schemes.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>4 out of 23 patients (17.4%) had experienced adverse effects, two of which had mild hepatic enzyme elevation and one had mild sinus bradycardia. Of note is that we haven't encountered any serious complications or life-threatening events during inpatient treatment. The most emphasised adverse effect in the literature, namely QTc prolongation and ECG changes, were not observed in our sample. The adverse effects were not found to be significantly associated with patient-related factors nor dose of antipsychotic medication.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>From our point of view, non-cardiac adverse effects should not be overlooked while treating comorbid psychiatric and COVID-19 patients.KEY POINTSAcute inpatient psychiatric treatment of patients who have comorbid COVID-19 is a complex situation requiring multidisciplinary action.Adverse drug reactions, which may or not result from the interaction of psychiatric and COVID-19 treatment, should be of concern for this patient group.While there is controversy over the benefits of some of the off-label COVID-19 medications, there should also be discussion over safety and concomitant medication use.In order to be adequately prepared for future escalations of COVID-19 pandemic, psychiatric services should thoroughly evaluate their initial experience with COVID-19, including from the point of drug effectiveness and safety.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33143519</PMID><DateRevised><Year>2021</Year><Month>05</Month><Day>08</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1471-1788</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Nov</Month><Day>04</Day></PubDate></JournalIssue><Title>International journal of psychiatry in clinical practice</Title><ISOAbbreviation>Int J Psychiatry Clin Pract</ISOAbbreviation></Journal><ArticleTitle>Adverse drug reactions associated with concurrent acute psychiatric treatment and Covid-19 drug therapy.</ArticleTitle><Pagination><MedlinePgn>1-5</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1080/13651501.2020.1843182</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="UNASSIGNED">Psychiatric patients are at increased risk of contamination, morbidity, and mortality associated with COVID-19, together with potentially more pronounced adverse effects. We present and discuss the adverse effects observed in an acute psychiatric clinic that has admitted COVID-19 patients during the first three months of the pandemic in Turkey.</AbstractText><AbstractText Label="METHODS" NlmCategory="UNASSIGNED">The COVID-19 treatment schemes were formed in accordance with the national and regional guidelines at the time of admittance, which were mainly based on the use of hydroxychloroquine and other drugs. The sample consisted exclusively of inpatients, and all patients were enrolled in the study regardless of their specific diagnosis or treatment schemes.</AbstractText><AbstractText Label="RESULTS" NlmCategory="UNASSIGNED">4 out of 23 patients (17.4%) had experienced adverse effects, two of which had mild hepatic enzyme elevation and one had mild sinus bradycardia. Of note is that we haven't encountered any serious complications or life-threatening events during inpatient treatment. The most emphasised adverse effect in the literature, namely QTc prolongation and ECG changes, were not observed in our sample. The adverse effects were not found to be significantly associated with patient-related factors nor dose of antipsychotic medication.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="UNASSIGNED">From our point of view, non-cardiac adverse effects should not be overlooked while treating comorbid psychiatric and COVID-19 patients.KEY POINTSAcute inpatient psychiatric treatment of patients who have comorbid COVID-19 is a complex situation requiring multidisciplinary action.Adverse drug reactions, which may or not result from the interaction of psychiatric and COVID-19 treatment, should be of concern for this patient group.While there is controversy over the benefits of some of the off-label COVID-19 medications, there should also be discussion over safety and concomitant medication use.In order to be adequately prepared for future escalations of COVID-19 pandemic, psychiatric services should thoroughly evaluate their initial experience with COVID-19, including from the point of drug effectiveness and safety.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Sönmez Güngör</LastName><ForeName>Ekin</ForeName><Initials>E</Initials><Identifier Source="ORCID">https://orcid.org/0000-0002-2874-4306</Identifier><AffiliationInfo><Affiliation>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul, Turkey.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yalçın</LastName><ForeName>Murat</ForeName><Initials>M</Initials><Identifier Source="ORCID">https://orcid.org/0000-0002-1129-8960</Identifier><AffiliationInfo><Affiliation>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul, Turkey.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yerebakan Tüzer</LastName><ForeName>Melike</ForeName><Initials>M</Initials><Identifier Source="ORCID">https://orcid.org/0000-0002-3096-8296</Identifier><AffiliationInfo><Affiliation>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul, Turkey.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Beşikçi Keleş</LastName><ForeName>Didem</ForeName><Initials>D</Initials><Identifier Source="ORCID">https://orcid.org/0000-0003-0407-5344</Identifier><AffiliationInfo><Affiliation>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul, Turkey.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Öcek Baş</LastName><ForeName>Tuba</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul, Turkey.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ergelen</LastName><ForeName>Mine</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul, Turkey.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bülbül</LastName><ForeName>Alper</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul, Turkey.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kırşavoğlu</LastName><ForeName>Betül</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul, Turkey.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Güneş</LastName><ForeName>Mustafa</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>University of Health Sciences, Erenköy Mental Health and Neurological Disorders Training and Research Hospital, Istanbul, Turkey.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>11</Month><Day>04</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Int J Psychiatry Clin Pract</MedlineTA><NlmUniqueID>9709509</NlmUniqueID><ISSNLinking>1365-1501</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">acute psychiatry</Keyword><Keyword MajorTopicYN="N">adverse drug reactions</Keyword><Keyword MajorTopicYN="N">drug side 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Güngör</name></noRegion><name sortKey="Be Ikci Kele, Didem" sort="Be Ikci Kele, Didem" uniqKey="Be Ikci Kele D" first="Didem" last="Be Ikçi Kele">Didem Be Ikçi Kele</name><name sortKey="Bulbul, Alper" sort="Bulbul, Alper" uniqKey="Bulbul A" first="Alper" last="Bülbül">Alper Bülbül</name><name sortKey="Ergelen, Mine" sort="Ergelen, Mine" uniqKey="Ergelen M" first="Mine" last="Ergelen">Mine Ergelen</name><name sortKey="Gune, Mustafa" sort="Gune, Mustafa" uniqKey="Gune M" first="Mustafa" last="Güne">Mustafa Güne</name><name sortKey="K R Avo Lu, Betul" sort="K R Avo Lu, Betul" uniqKey="K R Avo Lu B" first="Betül" last="K R Avo Lu">Betül K R Avo Lu</name><name sortKey="Ocek Ba, Tuba" sort="Ocek Ba, Tuba" uniqKey="Ocek Ba T" first="Tuba" last="Öcek Ba">Tuba Öcek Ba</name><name sortKey="Yalc N, Murat" sort="Yalc N, Murat" uniqKey="Yalc N M" first="Murat" last="Yalç N">Murat Yalç N</name><name sortKey="Yerebakan Tuzer, Melike" sort="Yerebakan Tuzer, Melike" uniqKey="Yerebakan Tuzer M" 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