COVID-19 inpatients with psychiatric disorders: Real-world clinical recommendations from an expert team in consultation-liaison psychiatry.
Identifieur interne : 000B67 ( Main/Exploration ); précédent : 000B66; suivant : 000B68COVID-19 inpatients with psychiatric disorders: Real-world clinical recommendations from an expert team in consultation-liaison psychiatry.
Auteurs : G. Anmella [Espagne] ; N. Arbelo [Espagne] ; G. Fico [Espagne] ; A. Murru [Espagne] ; C D Llach [Espagne] ; S. Madero [Espagne] ; S. Gomes-Da-Costa [Espagne] ; M L Imaz [Espagne] ; H. L Pez-Pelayo [Espagne] ; E. Vieta [Espagne] ; L. Pintor [Espagne]Source :
- Journal of affective disorders [ 1573-2517 ] ; 2020.
Abstract
BACKGROUND
The management of coronavirus disease 2019 (COVID-19) in patients with comorbid psychiatric disorders poses several challenges, especially regarding drug interactions.
METHODS
We report three representative case-scenarios on patients with psychiatric disorders and COVID-19 to provide a practical approach based on the existing literature and the clinical experience of an expert team in consultation-liaison psychiatry.
CASE-CENTERED RECOMMENDATIONS
Psychopharmacological ongoing treatments should be prioritized and most doses should be reduced 25-50% of original dose if the patient receives lopinavir/ritonavir, with some exceptions including quetiapine, asenapine, olanzapine, sertraline, lamotrigine, bupropion, and methadone. If the psychopharmacological usual doses are in the low-to-median range levels, a dose change during COVID-19 drugs co-administration is not recommended, but only ECG and clinical monitoring of adverse effects and drug levels if required. Furthermore, when introducing a psychopharmacological drug, dose titration should be progressive, with ECG monitoring if cardiotoxic interactions are present. (A) In agitated delirium, olanzapine is recommended as first-line antipsychotic and quetiapine should be avoided. (B) In severe mental illness (SMI), essential treatments should be maintained. (C) In non-SMI with depressive/anxiety symptoms, psychological support should be provided and symptoms identified and treated.
LIMITATIONS
Most recommendations on pharmacological interactions provide only a limited qualitative approach and quantitative recommendations are lacking.
CONCLUSIONS
Patients with psychiatric disorders and COVID-19 should be managed on a personalized basis considering several clinical criteria and, should not be excluded from receiving COVID-19 treatments. Risks of pharmacological interaction are not absolute and should be contextualized, and most psychopharmacological treatments should include an ECG with special attention to QTc interval.
DOI: 10.1016/j.jad.2020.05.149
PubMed: 32663933
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">COVID-19 inpatients with psychiatric disorders: Real-world clinical recommendations from an expert team in consultation-liaison psychiatry.</title><author><name sortKey="Anmella, G" sort="Anmella, G" uniqKey="Anmella G" first="G" last="Anmella">G. Anmella</name><affiliation wicri:level="1"><nlm:affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Arbelo, N" sort="Arbelo, N" uniqKey="Arbelo N" first="N" last="Arbelo">N. Arbelo</name><affiliation wicri:level="1"><nlm:affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Fico, G" sort="Fico, G" uniqKey="Fico G" first="G" last="Fico">G. Fico</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Murru, A" sort="Murru, A" uniqKey="Murru A" first="A" last="Murru">A. Murru</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Llach, C D" sort="Llach, C D" uniqKey="Llach C" first="C D" last="Llach">C D Llach</name><affiliation wicri:level="1"><nlm:affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Madero, S" sort="Madero, S" uniqKey="Madero S" first="S" last="Madero">S. Madero</name><affiliation wicri:level="1"><nlm:affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Gomes Da Costa, S" sort="Gomes Da Costa, S" uniqKey="Gomes Da Costa S" first="S" last="Gomes-Da-Costa">S. Gomes-Da-Costa</name><affiliation wicri:level="1"><nlm:affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Imaz, M L" sort="Imaz, M L" uniqKey="Imaz M" first="M L" last="Imaz">M L Imaz</name><affiliation wicri:level="1"><nlm:affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="L Pez Pelayo, H" sort="L Pez Pelayo, H" uniqKey="L Pez Pelayo H" first="H" last="L Pez-Pelayo">H. L Pez-Pelayo</name><affiliation wicri:level="2"><nlm:affiliation>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; GRAC, Addictions Unit, Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic, IDIBAPS, RETICS (Red de Trastornos adictivos), University of Barcelona, Villarroel, 170, 08036 Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; GRAC, Addictions Unit, Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic, IDIBAPS, RETICS (Red de Trastornos adictivos), University of Barcelona, Villarroel, 170, 08036 Barcelona</wicri:regionArea><placeName><region nuts="2" type="communauté">Catalogne</region></placeName></affiliation></author><author><name sortKey="Vieta, E" sort="Vieta, E" uniqKey="Vieta E" first="E" last="Vieta">E. Vieta</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Pintor, L" sort="Pintor, L" uniqKey="Pintor L" first="L" last="Pintor">L. Pintor</name><affiliation wicri:level="1"><nlm:affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain. Electronic address: LPINTOR@clinic.cat.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32663933</idno><idno type="pmid">32663933</idno><idno type="doi">10.1016/j.jad.2020.05.149</idno><idno type="wicri:Area/Main/Corpus">000128</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000128</idno><idno type="wicri:Area/Main/Curation">000128</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000128</idno><idno type="wicri:Area/Main/Exploration">000128</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">COVID-19 inpatients with psychiatric disorders: Real-world clinical recommendations from an expert team in consultation-liaison psychiatry.</title><author><name sortKey="Anmella, G" sort="Anmella, G" uniqKey="Anmella G" first="G" last="Anmella">G. Anmella</name><affiliation wicri:level="1"><nlm:affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Arbelo, N" sort="Arbelo, N" uniqKey="Arbelo N" first="N" last="Arbelo">N. Arbelo</name><affiliation wicri:level="1"><nlm:affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Fico, G" sort="Fico, G" uniqKey="Fico G" first="G" last="Fico">G. Fico</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Murru, A" sort="Murru, A" uniqKey="Murru A" first="A" last="Murru">A. Murru</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Llach, C D" sort="Llach, C D" uniqKey="Llach C" first="C D" last="Llach">C D Llach</name><affiliation wicri:level="1"><nlm:affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Madero, S" sort="Madero, S" uniqKey="Madero S" first="S" last="Madero">S. Madero</name><affiliation wicri:level="1"><nlm:affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Gomes Da Costa, S" sort="Gomes Da Costa, S" uniqKey="Gomes Da Costa S" first="S" last="Gomes-Da-Costa">S. Gomes-Da-Costa</name><affiliation wicri:level="1"><nlm:affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Imaz, M L" sort="Imaz, M L" uniqKey="Imaz M" first="M L" last="Imaz">M L Imaz</name><affiliation wicri:level="1"><nlm:affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="L Pez Pelayo, H" sort="L Pez Pelayo, H" uniqKey="L Pez Pelayo H" first="H" last="L Pez-Pelayo">H. L Pez-Pelayo</name><affiliation wicri:level="2"><nlm:affiliation>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; GRAC, Addictions Unit, Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic, IDIBAPS, RETICS (Red de Trastornos adictivos), University of Barcelona, Villarroel, 170, 08036 Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; GRAC, Addictions Unit, Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic, IDIBAPS, RETICS (Red de Trastornos adictivos), University of Barcelona, Villarroel, 170, 08036 Barcelona</wicri:regionArea><placeName><region nuts="2" type="communauté">Catalogne</region></placeName></affiliation></author><author><name sortKey="Vieta, E" sort="Vieta, E" uniqKey="Vieta E" first="E" last="Vieta">E. Vieta</name><affiliation wicri:level="1"><nlm:affiliation>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author><author><name sortKey="Pintor, L" sort="Pintor, L" uniqKey="Pintor L" first="L" last="Pintor">L. Pintor</name><affiliation wicri:level="1"><nlm:affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain. Electronic address: LPINTOR@clinic.cat.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia</wicri:regionArea><wicri:noRegion>Catalonia</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of affective disorders</title><idno type="eISSN">1573-2517</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>BACKGROUND</b></p><p>The management of coronavirus disease 2019 (COVID-19) in patients with comorbid psychiatric disorders poses several challenges, especially regarding drug interactions.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We report three representative case-scenarios on patients with psychiatric disorders and COVID-19 to provide a practical approach based on the existing literature and the clinical experience of an expert team in consultation-liaison psychiatry.</p></div><div type="abstract" xml:lang="en"><p><b>CASE-CENTERED RECOMMENDATIONS</b></p><p>Psychopharmacological ongoing treatments should be prioritized and most doses should be reduced 25-50% of original dose if the patient receives lopinavir/ritonavir, with some exceptions including quetiapine, asenapine, olanzapine, sertraline, lamotrigine, bupropion, and methadone. If the psychopharmacological usual doses are in the low-to-median range levels, a dose change during COVID-19 drugs co-administration is not recommended, but only ECG and clinical monitoring of adverse effects and drug levels if required. Furthermore, when introducing a psychopharmacological drug, dose titration should be progressive, with ECG monitoring if cardiotoxic interactions are present. (A) In agitated delirium, olanzapine is recommended as first-line antipsychotic and quetiapine should be avoided. (B) In severe mental illness (SMI), essential treatments should be maintained. (C) In non-SMI with depressive/anxiety symptoms, psychological support should be provided and symptoms identified and treated.</p></div><div type="abstract" xml:lang="en"><p><b>LIMITATIONS</b></p><p>Most recommendations on pharmacological interactions provide only a limited qualitative approach and quantitative recommendations are lacking.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Patients with psychiatric disorders and COVID-19 should be managed on a personalized basis considering several clinical criteria and, should not be excluded from receiving COVID-19 treatments. Risks of pharmacological interaction are not absolute and should be contextualized, and most psychopharmacological treatments should include an ECG with special attention to QTc interval.</p></div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">32663933</PMID><DateRevised><Year>2020</Year><Month>07</Month><Day>16</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1573-2517</ISSN><JournalIssue CitedMedium="Internet"><Volume>274</Volume><PubDate><Year>2020</Year><Month>09</Month><Day>01</Day></PubDate></JournalIssue><Title>Journal of affective disorders</Title><ISOAbbreviation>J Affect Disord</ISOAbbreviation></Journal><ArticleTitle>COVID-19 inpatients with psychiatric disorders: Real-world clinical recommendations from an expert team in consultation-liaison psychiatry.</ArticleTitle><Pagination><MedlinePgn>1062-1067</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0165-0327(20)31272-6</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jad.2020.05.149</ELocationID><Abstract><AbstractText Label="BACKGROUND">The management of coronavirus disease 2019 (COVID-19) in patients with comorbid psychiatric disorders poses several challenges, especially regarding drug interactions.</AbstractText><AbstractText Label="METHODS">We report three representative case-scenarios on patients with psychiatric disorders and COVID-19 to provide a practical approach based on the existing literature and the clinical experience of an expert team in consultation-liaison psychiatry.</AbstractText><AbstractText Label="CASE-CENTERED RECOMMENDATIONS">Psychopharmacological ongoing treatments should be prioritized and most doses should be reduced 25-50% of original dose if the patient receives lopinavir/ritonavir, with some exceptions including quetiapine, asenapine, olanzapine, sertraline, lamotrigine, bupropion, and methadone. If the psychopharmacological usual doses are in the low-to-median range levels, a dose change during COVID-19 drugs co-administration is not recommended, but only ECG and clinical monitoring of adverse effects and drug levels if required. Furthermore, when introducing a psychopharmacological drug, dose titration should be progressive, with ECG monitoring if cardiotoxic interactions are present. (A) In agitated delirium, olanzapine is recommended as first-line antipsychotic and quetiapine should be avoided. (B) In severe mental illness (SMI), essential treatments should be maintained. (C) In non-SMI with depressive/anxiety symptoms, psychological support should be provided and symptoms identified and treated.</AbstractText><AbstractText Label="LIMITATIONS">Most recommendations on pharmacological interactions provide only a limited qualitative approach and quantitative recommendations are lacking.</AbstractText><AbstractText Label="CONCLUSIONS">Patients with psychiatric disorders and COVID-19 should be managed on a personalized basis considering several clinical criteria and, should not be excluded from receiving COVID-19 treatments. Risks of pharmacological interaction are not absolute and should be contextualized, and most psychopharmacological treatments should include an ECG with special attention to QTc interval.</AbstractText><CopyrightInformation>Copyright © 2020 Elsevier B.V. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Anmella</LastName><ForeName>G</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Arbelo</LastName><ForeName>N</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fico</LastName><ForeName>G</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Murru</LastName><ForeName>A</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Llach</LastName><ForeName>C D</ForeName><Initials>CD</Initials><AffiliationInfo><Affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Madero</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gomes-da-Costa</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Imaz</LastName><ForeName>M L</ForeName><Initials>ML</Initials><AffiliationInfo><Affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>López-Pelayo</LastName><ForeName>H</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; GRAC, Addictions Unit, Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic, IDIBAPS, RETICS (Red de Trastornos adictivos), University of Barcelona, Villarroel, 170, 08036 Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vieta</LastName><ForeName>E</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pintor</LastName><ForeName>L</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain. Electronic address: LPINTOR@clinic.cat.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>06</Month><Day>01</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>J Affect Disord</MedlineTA><NlmUniqueID>7906073</NlmUniqueID><ISSNLinking>0165-0327</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">COVID-19</Keyword><Keyword MajorTopicYN="Y">Consultation liaison psychiatry</Keyword><Keyword MajorTopicYN="Y">Interactions</Keyword><Keyword MajorTopicYN="Y">Psychiatry</Keyword><Keyword MajorTopicYN="Y">Psychodrug</Keyword><Keyword MajorTopicYN="Y">Psychopharmacology</Keyword></KeywordList><CoiStatement>Declaration of Competing Interest Dr. Anmella has received CME-related honoraria, or consulting fees from Janssen-Cilag, Lundbeck and Angelini and reports no financial or other relationship relevant to the subject of this article. Dr. Arbelo has received CME-related financing and travel grants from Janssen-Cilag and Lundbeck and reports no financial or other relationship relevant to the subject of this article. Dr. Fico has received CME-related honoraria, or consulting fees from Janssen-Cilag and Lundbeck. Dr. Llach has received CME-related financing and travel grants from Janssen-Cilag and reports no financial or other relationship relevant to the subject of this article. Dr. Madero has received travel grants and CME-related honoraria from Janssen-Cilag, Lundbeck, Pfizer and Angelini and reports no financial or other relationship relevant to the subject of this article. Dr. Gomes-da-Costa has received CME-related honoraria, or consulting fees from Janssen-Cilag, Lundbeck, Italfarmaco and Angelini and reports no financial or other relationship relevant to the subject of this article. Dr. López-Pelayo has received travel grants from the laboratories honoraria and travel grants from Janssen and Lundbeck. None of them has relationship with this research. Prof. Vieta has received research support from or served as consultant, adviser or speaker for AB-Biotics, Abbott, Actavis, Allergan, Angelini, AstraZeneca, Bristol-Myers Squibb, Dainippon Sumitomo Pharma, Ferrer, Forest Research Institute, Gedeon Richter, Glaxo-Smith-Kline, Janssen, Lundbeck, Otsuka, Pfizer, Roche, Sage pharmaceuticals, Sanofi-Aventis, Servier, Shire, Sunovion, Takeda, Telefónica, the Brain and Behaviour Foundation, the Spanish Ministry of Science and Innovation (CIBERSAM), the Seventh European Framework Programme (ENBREC), and the Stanley Medical Research Institute. All other authors declare no conflict of interests.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>04</Month><Day>10</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>05</Month><Day>20</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>05</Month><Day>22</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>7</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>7</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>7</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32663933</ArticleId><ArticleId IdType="pii">S0165-0327(20)31272-6</ArticleId><ArticleId IdType="doi">10.1016/j.jad.2020.05.149</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Espagne</li></country><region><li>Catalogne</li></region></list><tree><country name="Espagne"><noRegion><name sortKey="Anmella, G" sort="Anmella, G" uniqKey="Anmella G" first="G" last="Anmella">G. Anmella</name></noRegion><name sortKey="Arbelo, N" sort="Arbelo, N" uniqKey="Arbelo N" first="N" last="Arbelo">N. Arbelo</name><name sortKey="Fico, G" sort="Fico, G" uniqKey="Fico G" first="G" last="Fico">G. Fico</name><name sortKey="Gomes Da Costa, S" sort="Gomes Da Costa, S" uniqKey="Gomes Da Costa S" first="S" last="Gomes-Da-Costa">S. Gomes-Da-Costa</name><name sortKey="Imaz, M L" sort="Imaz, M L" uniqKey="Imaz M" first="M L" last="Imaz">M L Imaz</name><name sortKey="L Pez Pelayo, H" sort="L Pez Pelayo, H" uniqKey="L Pez Pelayo H" first="H" last="L Pez-Pelayo">H. L Pez-Pelayo</name><name sortKey="Llach, C D" sort="Llach, C D" uniqKey="Llach C" first="C D" last="Llach">C D Llach</name><name sortKey="Madero, S" sort="Madero, S" uniqKey="Madero S" first="S" last="Madero">S. Madero</name><name sortKey="Murru, A" sort="Murru, A" uniqKey="Murru A" first="A" last="Murru">A. Murru</name><name sortKey="Pintor, L" sort="Pintor, L" uniqKey="Pintor L" first="L" last="Pintor">L. Pintor</name><name sortKey="Vieta, E" sort="Vieta, E" uniqKey="Vieta E" first="E" last="Vieta">E. Vieta</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/CovidPsychoV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000B67 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000B67 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= CovidPsychoV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= pubmed:32663933
|texte= COVID-19 inpatients with psychiatric disorders: Real-world clinical recommendations from an expert team in consultation-liaison psychiatry.
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:32663933" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a CovidPsychoV1
| This area was generated with Dilib version V0.6.35. |  |